Provider Demographics
NPI:1417497173
Name:PAUL KRAMER MD
Entity Type:Organization
Organization Name:PAUL KRAMER MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-791-7285
Mailing Address - Street 1:1098 SUNRISE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4467
Mailing Address - Country:US
Mailing Address - Phone:916-791-7285
Mailing Address - Fax:916-791-7010
Practice Address - Street 1:1098 SUNRISE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4467
Practice Address - Country:US
Practice Address - Phone:916-791-7285
Practice Address - Fax:916-791-7010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63457261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G634570OtherMEDICARE PTAN
CAE30904Medicare UPIN