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General NPI Number Information
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NPI Number | 1558329920
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Entity Type | Individual
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Provider Name | THOMAS F KRENEK IV MD
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Gender | Male
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 03/18/2013
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Provider Practice Location Address
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Address Line | 2200 HARRISON AVE
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City | EUREKA
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State | CA
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Zip | 95501-3215
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Country | US
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Telephone | 707-269-9550
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 692
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City | BAYSIDE
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State | CA
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Zip | 95524-0692
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Country | US
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Telephone | 707-269-9550
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | G43797
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G43797
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License Number State | CA
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