Provider Demographics
NPI:1790794048
Name:KRAMER, PAUL EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:EDWARD
Last Name:KRAMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1098 SUNRISE AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4469
Mailing Address - Country:US
Mailing Address - Phone:916-967-7285
Mailing Address - Fax:916-967-7289
Practice Address - Street 1:1098 SUNRISE AVE
Practice Address - Street 2:STE 100
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4469
Practice Address - Country:US
Practice Address - Phone:916-967-7285
Practice Address - Fax:916-967-7289
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2016-11-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG63457207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE30904Medicare UPIN