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General NPI Number Information
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NPI Number | 1780942110
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Entity Type | Individual
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Provider Name | JOSEPH PAUL KRACHENFELS JR. D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 04/23/2012
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Provider Practice Location Address
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Address Line | 13193 CENTRAL AVE STE 100
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City | CHINO
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State | CA
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Zip | 91710-4179
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Country | US
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Telephone | 631-404-9394
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Fax |
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Provider Business Mailing Address
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Address Line | 1110 E PHILADELPHIA ST UNIT 1216
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City | ONTARIO
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State | CA
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Zip | 91761-8413
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Country | US
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Telephone | 631-404-9394
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A11816
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License Number State | CA
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