Crown City Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CROWN CITY MEDICAL GROUP, INC.

Practice address

1542 E Florence Ave
Los Angeles, CA 90001-2536

Phone

(323) 584-0222

Fax

(626) 296-1403

NPI assigned

Apr 6, 2007

Organization subpart

No

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

Authorized official

Name

Kevin B. Tyson, M.D.

Title

Medical Director

Phone

(626) 798-8792

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406505600000",
    "number": "1962525964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1542 E FLORENCE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900012536",
            "telephone_number": "323-584-0222",
            "fax_number": "626-296-1403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 E FLORENCE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900012536",
            "telephone_number": "323-584-0222",
            "fax_number": "626-296-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWN CITY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2014-07-28",
        "status": "A",
        "authorized_official_last_name": "TYSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "626-798-8792",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROVIDER #",
            "identifier": "GR0041813",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Crowe, LCSW
• Kristen Kerry Crowe
• Catherine Magdalena Crowell
• Crown Care Cranial Prosthetics LLC
• Crown Care Pharmacy Inc
• Crown Medical Center, Inc.
• Martyn Felix Crown
• David R Crowninshield II II, CRNA
• Golda Rosete Crowther, NPS-RRT
• Daniel Martin Croymans, M.D., M.B.A., M.S.

• All providers in Los Angeles, CA
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2014; 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.