Healthcare Provider Details

I. General information

NPI: 1114950060
Provider Name (Legal Business Name): HOWARD R KRAUSS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 08/04/2023
Certification Date: 08/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2125 ARIZONA AVE
SANTA MONICA CA
90404-1337
US

IV. Provider business mailing address

2125 ARIZONA AVE
SANTA MONICA CA
90404-1337
US

V. Phone/Fax

Practice location:
  • Phone: 310-829-8701
  • Fax: 310-315-4062
Mailing address:
  • Phone: 131-082-9870
  • Fax: 310-477-7281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberG37539
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207WX0109X
TaxonomyNeuro-ophthalmology Physician
License NumberG37539
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: