Provider Demographics
NPI:1558547752
Name:KRATZBERG, YVETTE PRADO (MD)
Entity Type:Individual
Prefix:DR
First Name:YVETTE
Middle Name:PRADO
Last Name:KRATZBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2239 PORT LERWICK PL
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5424
Mailing Address - Country:US
Mailing Address - Phone:949-640-4003
Mailing Address - Fax:
Practice Address - Street 1:2465 LATHAM ST STE 300
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4792
Practice Address - Country:US
Practice Address - Phone:650-268-9806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-17
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA68830208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics