Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | E4033 | CA |
NPI | 1386746477 |
---|---|
Provider Name | Dr. Victor Gregory Krall |
First Address | Torrance, CA 90503-4826 |
Second Address | Torrance, CA 90503-4826 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2006 |
Last Update Date | 03/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U65389 | (02) | CA |