Healthcare Provider Details

I. General information

NPI: 1689772865
Provider Name (Legal Business Name): BARAK KRAUS DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 09/15/2023
Certification Date: 09/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16573 VENTURA BLVD STE 8
ENCINO CA
91436-2024
US

IV. Provider business mailing address

16573 VENTURA BLVD SUITE 8
ENCINO CA
91436-2024
US

V. Phone/Fax

Practice location:
  • Phone: 818-986-7266
  • Fax: 818-907-3890
Mailing address:
  • Phone: 818-986-7266
  • Fax: 818-287-6783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number32417
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: