Kraut, Jeffrey Malcolm

Kraut, Jeffrey Malcolm is an individual health care provider with primary practice located at 510 Cypress St Ste D , Fort Bragg CA 95437-5411. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as his primary health care specialty. Kraut, Jeffrey Malcolm can be contacted via phone (707) 964-5696.

Contact Information

Primary practice address
510 Cypress St Ste D Fort Bragg CA 95437-5411
Phone: (707) 964-5696
Fax: (707) 964-6274
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X G21238 California

Profile Details

NPI number 1285657189
LBN Legal business name Kraut, Jeffrey Malcolm
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285657189 NPPES
California MEDICAID OOG212380

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