Provider Demographics
NPI:1598774101
Name:KRENZ, ELIZABETH I (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:I
Last Name:KRENZ
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:PO BOX 62106
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93160-2106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4151 FOOTHILL RD # ROD
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1110
Practice Address - Country:US
Practice Address - Phone:805-681-6550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99889207L00000X
LAMD.203291207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04253843Medicaid
EK080573OtherCOMMERCIAL-COMMERCIAL NUMBER
LA1807206Medicaid
EK080573OtherCHAMPUS-CHAMPUS
MI490634210Medicaid
050H262180OtherBLUE CROSS-BLUE CROSS
EK080573OtherCOMMERCIAL-COMMERCIAL NUMBER
0H26218126Medicare ID - Type Unspecified
I59379Medicare UPIN