Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | A167441 | CA |
NPI | 1033644844 |
---|---|
Provider Name | Kathleen Kramer |
First Address | San Diego, CA 92101-2393 |
Second Address | San Diego, CA 92101-2393 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2017 |
Last Update Date | 14/10/2020 |