Healthcare Provider Details

I. General information

NPI: 1619950714
Provider Name (Legal Business Name): RENE' C. KRONLAND MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 07/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1061 E MAIN ST SUITE 201
GRASS VALLEY CA
95945-5724
US

IV. Provider business mailing address

1061 E MAIN ST SUITE 201
GRASS VALLEY CA
95945-5724
US

V. Phone/Fax

Practice location:
  • Phone: 530-271-0604
  • Fax: 530-271-0622
Mailing address:
  • Phone: 530-271-0604
  • Fax: 530-271-0622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberG085096
License Number StateCA

VIII. Authorized Official

Name: RENE C KRONLAND
Title or Position: DOCTOR
Credential: MD
Phone: 530-271-0604