Provider Demographics
NPI:1720187271
Name:KRAMER, BARRY ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:ALAN
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:PO BOX 5792
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90209-5792
Mailing Address - Country:US
Mailing Address - Phone:323-932-5475
Mailing Address - Fax:323-932-5205
Practice Address - Street 1:5900 W OLYMPIC BLVD
Practice Address - Street 2:3-WEST
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4671
Practice Address - Country:US
Practice Address - Phone:323-932-5475
Practice Address - Fax:323-932-5205
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG312952084P0800X, 2084P0805X
FLME 638602084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA91334Medicare UPIN
CAG31295Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER