Cristal Dawn Speller, MD, MPH

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A62390 Issued in CA

Practice address

230 N Maryland Ave Ste 110
Glendale, CA 91206-4283

Phone

(818) 551-0464

Fax

(818) 551-0462

NPI assigned

May 9, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Prohealth Partners a Medical Group Inc

  • Obstetrics & Gynecology Physician
  • Torrance, CA
  • NPI 1356882435

  Pediatrics

  NPD
• Prohealth Partners, a Medical Group

  • Internal Medicine Physician
  • Lakewood, CA
  • NPI 1003949975
  NPD
• Prohealth Partners, a Medical Group, Inc.

  • Internal Medicine Physician
  • Pico Rivera, CA
  • NPI 1912899394
  NPD

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1609168608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N MARYLAND AVE STE 110",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064283",
            "telephone_number": "818-551-0464",
            "fax_number": "818-551-0462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N MARYLAND AVE STE 110",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064283",
            "telephone_number": "818-551-0464",
            "fax_number": "818-551-0462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPELLER",
        "first_name": "CRISTAL",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-09",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A62390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spectrum Hospice, Inc,
• Speech Guy, LLC
• Speech Therapy Team
• Speechfit, a Speech Language Pathology Corporation
• Speedy Home Care, Inc.
• John Raymond Spence, M.D.
• Marisa Spinella
• Spirit Medical Group
• Spiritual Comfort Home Care, Inc.
• Spiritual Comfort Hospice Care, Inc.

• Family Medicine Physician in Glendale, CA
• Providers in Glendale, 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 May 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.