Individual
KRISTA LEANNA KAUPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2823 FRESNO ST, FRESNO, CA 93721-1324
(559) 459-3770
(559) 459-3719
Mailing address
2625 E DIVISADERO ST, FRESNO, CA 93721-1431
(559) 443-2682
(559) 443-2681
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
G80370
CA
2086S0102X
Surgical Critical Care Physician
Primary
G80370
CA
2086S0127X
Trauma Surgery Physician
G80370
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G803700
—
CA
Enumeration date
08/30/2006
Last updated
01/14/2020
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