Healthcare Provider Details

I. General information

NPI: 1548437809
Provider Name (Legal Business Name): RACHAEL I. KRAUSE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. RACHAEL I. ZWEIG

II. Dates (important events)

Enumeration Date: 05/14/2008
Last Update Date: 05/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17100 EUCLID STREET PICU/PEDS DEPARTMENT
FOUNTAIN VALLEY CA
92708
US

IV. Provider business mailing address

17100 EUCLID STREET PICU/PEDS DEPARTMENT
FOUNTAIN VALLEY CA
92708
US

V. Phone/Fax

Practice location:
  • Phone: 714-966-7253
  • Fax: 714-966-3354
Mailing address:
  • Phone: 714-966-7253
  • Fax: 714-966-3354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA102002
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: