Provider Demographics
NPI:1659671048
Name:KRAUS, DAVID RICHARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:RICHARD
Last Name:KRAUS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1748 TATIANA ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-4813
Mailing Address - Country:US
Mailing Address - Phone:916-803-0087
Mailing Address - Fax:530-401-9966
Practice Address - Street 1:2550 BELL ROAD
Practice Address - Street 2:SAFEWAY PHARMACY
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603
Practice Address - Country:US
Practice Address - Phone:530-401-9979
Practice Address - Fax:530-401-9966
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38833183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist