Provider Demographics
NPI:1215165667
Name:NEAL-KRAAL, REBEKAH ADIA (MD)
Entity type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:ADIA
Last Name:NEAL-KRAAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:10861 CHERRY ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-5402
Mailing Address - Country:US
Mailing Address - Phone:562-794-9801
Mailing Address - Fax:562-685-0570
Practice Address - Street 1:10861 CHERRY ST
Practice Address - Street 2:SUITE 104
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720
Practice Address - Country:US
Practice Address - Phone:562-794-9801
Practice Address - Fax:562-685-0570
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA113701207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FS345YMedicare PIN