Provider Demographics
NPI:1033439583
Name:KRAUS, KENNETH FREDERICK (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:FREDERICK
Last Name:KRAUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2009 YACHT RESOLUTE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-6720
Mailing Address - Country:US
Mailing Address - Phone:949-760-1999
Mailing Address - Fax:
Practice Address - Street 1:2009 YACHT RESOLUTE
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-6720
Practice Address - Country:US
Practice Address - Phone:949-760-1999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGFE7778207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology