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General NPI Number Information
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NPI Number | 1932497914
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Entity Type | Individual
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Provider Name | VIT DANIEL KRAUSHAAR M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/12/2011
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Last Update Date | 01/08/2015
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Provider Practice Location Address
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Address Line | 75 NEILSON ST
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City | WATSONVILLE
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State | CA
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Zip | 95076-2468
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Country | US
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Telephone | 831-763-6412
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Fax |
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Provider Business Mailing Address
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Address Line | 91 S BRANCIFORTE AVE
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City | SANTA CRUZ
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State | CA
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Zip | 95062-3361
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Country | US
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Telephone | 415-732-9717
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 4301099307
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License Number State | MI
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