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General NPI Number Information
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NPI Number | 1750315727
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Entity Type | Organization
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Legal Business Name | STEPHEN M. KRAUSE M.D. A MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 12/03/2007
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Provider Practice Location Address
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Address Line | 1025 5TH ST
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City | NOVATO
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State | CA
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Zip | 94945-2413
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Country | US
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Telephone | 415-897-1733
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 5TH ST
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City | NOVATO
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State | CA
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Zip | 94945-2413
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Country | US
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Telephone | 415-897-1733
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEPHEN M. KRAUSE
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Credential | M.D.
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Telephone | 415-897-1733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G13080
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License Number State | CA
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