Provider Demographics
NPI:1477691988
Name:KRUEGER, HARALD SIEGFRIED (MD)
Entity Type:Individual
Prefix:DR
First Name:HARALD
Middle Name:SIEGFRIED
Last Name:KRUEGER
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 1:43422 25TH ST W
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-5212
Mailing Address - Country:US
Mailing Address - Phone:661-728-0671
Mailing Address - Fax:
Practice Address - Street 1:349 A E. AVE. K-6
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535
Practice Address - Country:US
Practice Address - Phone:661-723-4260
Practice Address - Fax:661-723-6975
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA378742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA37874AOtherPPIN
CAW2983LMedicare ID - Type Unspecified
CAWA37874AOtherPPIN