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Individual

DR. EUGENE MARVIN KRANK JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
4358 W 136TH ST, #D, HAWTHORNE, CA 90250-7127
(310) 219-3339
Mailing address
4358 W 136TH ST, #D, HAWTHORNE, CA 90250-7127
(310) 219-3339

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
0103000955
VA
213ES0131X
Foot Surgery Podiatrist
Primary
PD155R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0103000955
STATE LICENSE
VA
01
PD155R
STATE LICENSE
LA
Enumeration date
08/08/2009
Last updated
08/08/2009
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