Provider Demographics
NPI:1649310277
Name:KRAMER, STUART BERYL (MD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:BERYL
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 1:5530 CORBIN AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-6030
Mailing Address - Country:US
Mailing Address - Phone:818-716-5179
Mailing Address - Fax:818-716-6978
Practice Address - Street 1:5530 CORBIN AVE STE 260
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6030
Practice Address - Country:US
Practice Address - Phone:818-716-5179
Practice Address - Fax:818-716-6978
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG18896207RE0101X, 261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism