Provider Demographics
NPI:1508880147
Name:JOSEPH W KRAUT JR MD, INC
Entity Type:Organization
Organization Name:JOSEPH W KRAUT JR MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:KRAUT
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:408-779-7696
Mailing Address - Street 1:18181 BUTTERFIELD BLVD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-8112
Mailing Address - Country:US
Mailing Address - Phone:408-779-7696
Mailing Address - Fax:408-779-5546
Practice Address - Street 1:18181 BUTTERFIELD BLVD
Practice Address - Street 2:SUITE 180
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-8112
Practice Address - Country:US
Practice Address - Phone:408-779-7696
Practice Address - Fax:408-779-5546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG074436207R00000X
CAG74436207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G744360Medicaid
CA00G744362Medicaid
CA00G744362Medicaid
CAZZZ025852Medicare PIN
CA00G744360Medicaid