Active NPI
David William Crotty, D.O.
- Neuromusculoskeletal Medicine & OMM Physician
- Vallejo, CA
National Provider Identifier
1275975302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuromusculoskeletal Medicine & OMM Physician
- License
- CA4982
- Practice address
- 1310 Club Dr
Mare Island
Vallejo, CA 94592-1187 - Phone
- (707) 638-5216
- Fax
- (707) 638-5946
- NPI assigned
- Jul 17, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuromusculoskeletal Medicine & OMM Physician | 204D00000X | CA4982 | CA | Primary |
Addresses
Primary practice location
1310 Club Dr
Mare Island
Vallejo, CA 94592-1187
Mailing address
1310 Club Dr
Mare Island
Vallejo, CA 94592-1187
Phone (707) 638-5216
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CA4982 | CA | MD | Neuromusculoskeletal Medicine & OMM Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374019200000",
"number": "1275975302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1310 CLUB DR",
"address_2": "MARE ISLAND",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945921187",
"telephone_number": "707-638-5216",
"fax_number": "707-638-5946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 CLUB DR",
"address_2": "MARE ISLAND",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945921187",
"telephone_number": "707-638-5216",
"fax_number": "707-638-5946"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROTTY",
"first_name": "DAVID",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-07-17",
"last_updated": "2013-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "204D00000X",
"taxonomy_group": "",
"desc": "Neuromusculoskeletal Medicine & OMM",
"state": "CA",
"license": "CA4982",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.