MEDICARE: MICHELE KRAFT DPM

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
1	213E00000X	Podiatrist	E3521	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BB074	OTHER	CA	MEDICARE PTAN- GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	1124120654	OTHER	CA	NPI- GROUP

General Provider Information

NPI Number	:	1861499782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE KRAFT DPM

Provider Business Mailing Address
First Line	:	547 FREDERICK ST
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95062-2635
Country	:	US
Telephone Number	:	831-425-8637
Fax Number	:	831-425-8634

Provider Business Practice Location Address
First Line	:	26615 CARMEL CENTER PL STE 103
Second Line	:
City	:	CARMEL
State	:	CA
Zip	:	93923-8654
Country	:	US
Telephone Number	:	831-425-8637
Fax Number	:	831-425-8634

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/21/2022

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Directions to “ MICHELE KRAFT DPM” Practice Location

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