David Alan Craddock

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A5766 Issued in CA

Practice address

27660 Santa Margarita Pkwy
Mission Viejo, CA 92691-6674

Phone

(949) 951-7111

Fax

(949) 951-2524

NPI assigned

Dec 29, 2013

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. David Alan Craddock Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1388275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388275200000",
    "number": "1073934626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27660 SANTA MARGARITA PKWY",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916674",
            "telephone_number": "949-951-7111",
            "fax_number": "949-951-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27660 SANTA MARGARITA PKWY",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916674",
            "telephone_number": "949-951-7111",
            "fax_number": "949-951-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRADDOCK",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-29",
        "last_updated": "2013-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A5766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "CRADDOCK",
            "middle_name": "ALAN",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Family Medicine Physician in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.