Healthcare Provider Details

I. General information

NPI: 1982631917
Provider Name (Legal Business Name): PAUL ROBERT KRUPER D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 06/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 S ZEDIKER AVE
PARLIER CA
93648-2666
US

IV. Provider business mailing address

2601 - 19 AVE.
KINGSBURG CA
93631-1248
US

V. Phone/Fax

Practice location:
  • Phone: 559-646-6618
  • Fax:
Mailing address:
  • Phone: 559-897-2645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE2411
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: