Provider Demographics
NPI:1275626905
Name:KRAUSE, HILARY BLYTHE (MD)
Entity Type:Individual
Prefix:DR
First Name:HILARY
Middle Name:BLYTHE
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HILARY
Other - Middle Name:BLYTHE
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3500 5TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-5020
Mailing Address - Country:US
Mailing Address - Phone:619-295-3911
Mailing Address - Fax:619-295-4356
Practice Address - Street 1:3500 5TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5020
Practice Address - Country:US
Practice Address - Phone:619-295-3911
Practice Address - Fax:619-295-4356
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2023-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA90650208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics