MEDICARE: DR. DAVID KRASNOW OD, MPH, MBA

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	152W00000X	Optometrist	5548T	CA

General Provider Information

NPI Number	:	1609857820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID KRASNOW OD, MPH, MBA

Provider Business Mailing Address
First Line	:	9033 WILSHIRE BLVD
Second Line	:	SUITE 402
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-1837
Country	:	US
Telephone Number	:	310-276-5333
Fax Number	:	310-276-8830

Provider Business Practice Location Address
First Line	:	9033 WILSHIRE BLVD
Second Line	:	SUITE 402
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-1837
Country	:	US
Telephone Number	:	310-276-5333
Fax Number	:	310-276-8830

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

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	07/08/2007

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