Provider Demographics
NPI:1407845886
Name:KRAMER, DAVID STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:STEVEN
Last Name:KRAMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3356 W BALL RD STE 206
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3728
Mailing Address - Country:US
Mailing Address - Phone:714-827-8890
Mailing Address - Fax:714-827-8905
Practice Address - Street 1:3356 W BALL RD STE 206
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3728
Practice Address - Country:US
Practice Address - Phone:714-827-8890
Practice Address - Fax:714-827-8905
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG49359207RC0000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G493590Medicaid
CA00G493590Medicaid