Basic Information
Provider Information
NPI: 1386798932
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KROPF
FirstName: MICHAEL
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 5978
Address2:  
City: FULLERTON
State: CA
PostalCode: 928380978
CountryCode: US
TelephoneNumber: 7149925292
FaxNumber: 7149921956
Practice Location
Address1: 1301 20TH ST
Address2: SUITE 400
City: SANTA MONICA
State: CA
PostalCode: 904042050
CountryCode: US
TelephoneNumber: 3108287757
FaxNumber: 3108286687
Other Information
ProviderEnumerationDate: 01/22/2007
LastUpdateDate: 07/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XS0117XG56288CAY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine

ID Information
IDTypeStateIssuerDescription
00G56288001CABLUE SHIELD ID#OTHER


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