Doctor Name: | CRYSTAL MACKALL |
NPI Number: | 1003261660 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 140084 |
Business Practice Address: | 265 Campus Dr G3141a, Mc5456 Stanford, CA - 943055101 |
Business Phone Number: | 6507252553 |
Business Fax Number: | |
Mailing Address: | 265 Campus Dr, G3141a, Mc5456 STANFORD |
State: | CA |
Postal Code: | 943055101 |
Phone Number: | 6507252553 |
Fax Number: | |
NPI Enumeration Date: | 05/02/2016 |
NPI Last Update Date: | 05/02/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2080P0207X |
License Number: | 140084 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Pediatrics |
Taxonomy Specialization: | Pediatric Hematology-Oncology |
Taxonomy Definition: | A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |