Healthcare Provider Details

I. General information

NPI: 1568647501
Provider Name (Legal Business Name): MICHAEL L. KRUEGER, D.O. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 01/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7033 N FRESNO ST STE. 301
FRESNO CA
93720-2976
US

IV. Provider business mailing address

7033 N FRESNO ST STE. 301
FRESNO CA
93720-2976
US

V. Phone/Fax

Practice location:
  • Phone: 559-438-8181
  • Fax: 559-438-8179
Mailing address:
  • Phone: 559-438-8181
  • Fax: 559-438-8179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number20A6760
License Number StateCA

VIII. Authorized Official

Name: DR. MICHAEL L. KRUEGER
Title or Position: DOCTOR
Credential: D.O.
Phone: 559-438-8181