Provider Demographics
NPI:1528084738
Name:KRAMER, DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
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 1:3031 TISCH WAY
Mailing Address - Street 2:STE 400
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2541
Mailing Address - Country:US
Mailing Address - Phone:408-244-2100
Mailing Address - Fax:408-244-6596
Practice Address - Street 1:3031 TISCH WAY
Practice Address - Street 2:STE 400
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2541
Practice Address - Country:US
Practice Address - Phone:408-244-2100
Practice Address - Fax:408-244-6596
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG20106174400000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G201060Medicaid
CABD713TMedicare PIN
CABD713WMedicare PIN
CABD713XMedicare PIN
CABD713SMedicare PIN
CABD713UMedicare PIN
CA00G201060Medicaid
CABD713ZMedicare PIN
CABD713YMedicare PIN
CA00G201060Medicare PIN