Jeffrey Crudo MD Corp

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

JEFFREY CRUDO MD CORP

Practice address

1100 S Coast Hwy Ste 206
Laguna Beach, CA 92651-2972

Phone

(949) 715-6890

NPI assigned

Mar 9, 2021

Organization subpart

No

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

Authorized official

Name

Jeffrey Crudo, MD

Title

Owner

Phone

(949) 715-6890

Specialties & licenses 1

Addresses

Other names 1

• Coast Medical and Botox Doing business as

Locations

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

{
    "created_epoch": "1615248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1821673062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S COAST HWY STE 206",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512972",
            "telephone_number": "949-715-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S COAST HWY STE 206",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512972",
            "telephone_number": "949-715-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY CRUDO MD CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-09",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A",
        "authorized_official_last_name": "CRUDO",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-715-6890",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coast Medical and Botox",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coast Medical and Botox",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Laguna Beach, CA
• Providers in Laguna Beach, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.