Provider Demographics
NPI:1386800795
Name:WEISS, CRYSTAL C (CO)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:C
Last Name:WEISS
Suffix:
Gender:F
Credentials:CO
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:7720 CARDINAL CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-3333
Mailing Address - Country:US
Mailing Address - Phone:858-292-7449
Mailing Address - Fax:858-292-5496
Practice Address - Street 1:1929 W VISTA WAY
Practice Address - Street 2:SUITE A
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-6004
Practice Address - Country:US
Practice Address - Phone:760-941-1323
Practice Address - Fax:760-941-6452
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist