Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 29468 | CA |
NPI | 1235231135 |
---|---|
Provider Name | Dr. Scott M. Kramer |
First Address | Los Angeles, CA 90028-5162 |
Second Address | Los Angeles, CA 90028-5162 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2006 |
Last Update Date | 08/07/2007 |