Healthcare Provider Details

I. General information

NPI: 1194708412
Provider Name (Legal Business Name): SUSAN FALZONE KRAUS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2412 3RD ST
HUGHSON CA
95326-9310
US

IV. Provider business mailing address

PO BOX 249
HUGHSON CA
95326-0249
US

V. Phone/Fax

Practice location:
  • Phone: 209-558-7250
  • Fax: 209-558-6033
Mailing address:
  • Phone: 209-355-8725
  • Fax: 209-558-8723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA83754
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: