Individual
DR. IVAN KRASNOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
127 BROADWAY STE 100, SANTA MONICA, CA 90401-2389
(215) 955-8420
Mailing address
127 BROADWAY STE 100, SANTA MONICA, CA 90401-2389
(310) 340-6616
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A198433
CA
2084P0800X
Psychiatry Physician
MD479185
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2019
Last updated
10/08/2024
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