Provider Demographics
NPI:1851586234
Name:THOMAS F. KRAUEL, O.D., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:THOMAS F. KRAUEL, O.D., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:F
Authorized Official - Last Name:KRAUEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:530-233-2020
Mailing Address - Street 1:1201 THOMASON LN
Mailing Address - Street 2:
Mailing Address - City:ALTURAS
Mailing Address - State:CA
Mailing Address - Zip Code:96101-3150
Mailing Address - Country:US
Mailing Address - Phone:530-233-2020
Mailing Address - Fax:530-233-5430
Practice Address - Street 1:1201 THOMASON LN
Practice Address - Street 2:
Practice Address - City:ALTURAS
Practice Address - State:CA
Practice Address - Zip Code:96101-3150
Practice Address - Country:US
Practice Address - Phone:530-233-2020
Practice Address - Fax:530-233-5430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT7507TPG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1851586234Medicaid
D01354OtherMEDICARE RAILROAD
CA1851586234OtherVISION SERVICE PLAN
CA12571OtherMEDICAL EYE SERVICES
CA1851586234Medicaid
CA6189920001Medicare NSC
CAAR802Medicare PIN