Provider Demographics
NPI:1023218161
Name:KRIEG, CAROLYN FRANCES (DO)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:FRANCES
Last Name:KRIEG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8550 SANTA MONICA BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-4496
Mailing Address - Country:US
Mailing Address - Phone:917-680-7563
Mailing Address - Fax:
Practice Address - Street 1:8550 SANTA MONICA BLVD FL 2
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-4496
Practice Address - Country:US
Practice Address - Phone:925-818-9432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10026207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine