Dr. Jeffrey Malcolm Kraut
Adolescent Medicine
510 Cypress St Ste D
Fort Bragg
, California 95437-5411
Dr. Jeffrey Malcolm Kraut
Adolescent Medicine
510 Cypress St Ste D
Fort Bragg
, California 95437-5411
(707) 964-6274
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About
Features
Specialties
- Adolescent Medicine
Languages spoken
- English
Location
First Address
- Dr. Jeffrey Malcolm Kraut
- 510 Cypress St Ste D
- Fort Bragg, CA
- Zip : 95437-5411
- Fax : (707) 964-6274
- Phone : (707) 964-5696
Second Address
- Dr. Jeffrey Malcolm Kraut
- 510 Cypress St Ste D
- Fort Bragg, CA
- Zip : 95437-5411
- Fax : (707) 964-6274
- Phone : (707) 964-5696
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080A0000X | Adolescent Medicine | G21238 | CA |
National Provider Identifier
| NPI | 1285657189 |
|---|---|
| Provider Name | Dr. Jeffrey Malcolm Kraut |
| First Address | Fort Bragg, CA 95437-5411 |
| Second Address | Fort Bragg, CA 95437-5411 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/07/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| A41214 | (02) | CA |
| OOG212380 | (05) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.