Provider Demographics
NPI:1194708412
Name:KRAUS, SUSAN FALZONE (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:FALZONE
Last Name:KRAUS
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 249
Mailing Address - Street 2:
Mailing Address - City:HUGHSON
Mailing Address - State:CA
Mailing Address - Zip Code:95326-0249
Mailing Address - Country:US
Mailing Address - Phone:209-355-8725
Mailing Address - Fax:209-558-8723
Practice Address - Street 1:2412 3RD ST
Practice Address - Street 2:
Practice Address - City:HUGHSON
Practice Address - State:CA
Practice Address - Zip Code:95326-9310
Practice Address - Country:US
Practice Address - Phone:209-558-7250
Practice Address - Fax:209-558-6033
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83754207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA121238OtherBOARD CERT #
CA00A837540Medicare ID - Type Unspecified
CA121238OtherBOARD CERT #
CA00A837540OtherBLUE SHIELD OF CA PIN
CA121238OtherBOARD CERT #