Provider Demographics
NPI:1104142934
Name:KRAINOCK, MICHAEL ROSS (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ROSS
Last Name:KRAINOCK
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:11234 ANDERSON ST
Mailing Address - Street 2:GRADUATE MEDICAL EDUCATION OFFICE CP 21005
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2804
Mailing Address - Country:US
Mailing Address - Phone:909-558-4289
Mailing Address - Fax:909-558-4872
Practice Address - Street 1:11234 ANDERSON ST
Practice Address - Street 2:GRADUATE MEDICAL EDUCATION OFFICE CP 21005
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2804
Practice Address - Country:US
Practice Address - Phone:909-558-4289
Practice Address - Fax:909-558-4872
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program