Provider Demographics
NPI:1710001649
Name:KRAMER, MARTIN CONRAD (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:CONRAD
Last Name:KRAMER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 LOMBARD ST APT 118
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-1157
Mailing Address - Country:US
Mailing Address - Phone:415-433-5359
Mailing Address - Fax:
Practice Address - Street 1:595 CASTRO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-2511
Practice Address - Country:US
Practice Address - Phone:415-529-4099
Practice Address - Fax:415-291-0489
Is Sole Proprietor?:No
Enumeration Date:2007-03-17
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA12310363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant