Healthcare Provider Details

I. General information

NPI: 1477580595
Provider Name (Legal Business Name): JAMES AARON KRAUS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 PARADISE RD
MODESTO CA
95351-3163
US

IV. Provider business mailing address

917 OAKDALE RD
MODESTO CA
95355-4593
US

V. Phone/Fax

Practice location:
  • Phone: 209-558-4000
  • Fax: 209-558-6033
Mailing address:
  • Phone: 209-558-7248
  • Fax: 209-558-8723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA91537
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: