Provider Demographics
NPI:1003853623
Name:KRAMER, DAVID J (MSPT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:J
Last Name:KRAMER
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16838 CALLE DE SARAH
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-1951
Mailing Address - Country:US
Mailing Address - Phone:310-903-3100
Mailing Address - Fax:818-474-0044
Practice Address - Street 1:16838 CALLE DE SARAH
Practice Address - Street 2:
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-1951
Practice Address - Country:US
Practice Address - Phone:310-903-3100
Practice Address - Fax:818-474-0044
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2020-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29256225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS96644Medicare UPIN
CAPT29256Medicare ID - Type Unspecified