Healthcare Provider Details

I. General information

NPI: 1841286440
Provider Name (Legal Business Name): NEIL KRAUS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 12/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 GREENFIELD AVE
SAN ANSELMO CA
94960-2449
US

IV. Provider business mailing address

130 GREENFIELD AVE
SAN ANSELMO CA
94960-2449
US

V. Phone/Fax

Practice location:
  • Phone: 415-456-3435
  • Fax: 415-456-3532
Mailing address:
  • Phone: 415-456-3435
  • Fax: 415-456-3532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC018847
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: