MEDICARE: DR. SONJA STUMME KRAFCIK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	C51621	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C51621	OTHER	CA	STATE MEDICAL LICENSE

General Provider Information

NPI Number	:	1598767170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SONJA STUMME KRAFCIK MD

Provider Business Mailing Address
First Line	:	25500 RANCHO NIGUEL RD
Second Line	:	SUITE 150
City	:	LAGUNA NIGUEL
State	:	CA
Zip	:	92677-7302
Country	:	US
Telephone Number	:	949-831-3686
Fax Number	:	949-831-3651

Provider Business Practice Location Address
First Line	:	25500 RANCHO NIGUEL RD
Second Line	:	SUITE 150
City	:	LAGUNA NIGUEL
State	:	CA
Zip	:	92677-7302
Country	:	US
Telephone Number	:	949-831-3686
Fax Number	:	949-831-3651

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	07/09/2014

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