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NPI Code Detail

MEDICARE: ANDREW D. KRASNOFF M.D.

MEDICARE: ANDREW D. KRASNOFF M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080A0000XPediatric Adolescent Medicine PhysicianG48788CA

General Provider Information

NPI Number : 1528158300
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW D. KRASNOFF M.D.
Provider Business Mailing Address
First Line : 5400 BALBOA BLVD STE 326
Second Line :
City : ENCINO
State : CA
Zip : 91316-5214
Country : US
Telephone Number : 818-789-8987
Fax Number : 818-789-6726
Provider Business Practice Location Address
First Line : 5400 BALBOA BLVD STE 326
Second Line :
City : ENCINO
State : CA
Zip : 91316-5214
Country : US
Telephone Number : 818-789-8987
Fax Number : 818-789-6726
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2006
Last Update Date : 07/08/2007

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