Provider Demographics
NPI:1518042514
Name:KRAUSS, RONALD M (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:M
Last Name:KRAUSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 TELEGRAPH AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705
Mailing Address - Country:US
Mailing Address - Phone:510-665-0500
Mailing Address - Fax:510-665-3177
Practice Address - Street 1:3101 TELEGRAPH AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705
Practice Address - Country:US
Practice Address - Phone:510-665-0500
Practice Address - Fax:510-665-3177
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00G258130207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAK5955426OtherDEA
A42802Medicare UPIN
CA00G258130Medicare ID - Type Unspecified