Individual
THOMAS A. KRAFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1409 E BRIGGSMORE AVE, MODESTO, CA 95355-2707
(209) 550-4720
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA12920
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0PA129200
—
CA
Enumeration date
05/06/2006
Last updated
08/31/2010
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