Healthcare Provider Details

I. General information

NPI: 1659671048
Provider Name (Legal Business Name): DAVID RICHARD KRAUS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2010
Last Update Date: 11/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 BELL ROAD SAFEWAY PHARMACY
AUBURN CA
95603
US

IV. Provider business mailing address

1748 TATIANA ST
ROSEVILLE CA
95747-4813
US

V. Phone/Fax

Practice location:
  • Phone: 530-401-9979
  • Fax: 530-401-9966
Mailing address:
  • Phone: 916-803-0087
  • Fax: 530-401-9966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number38833
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: