Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0300X | Geriatric Medicine | 20A13886 | CA |
Y | 208200000X | Surgeon | OS006345L | PA |
Y | 208600000X | Surgeon | OS006345L | PA |
N | 208D00000X | General Practice Physician | 20A13886 | CA |
NPI | 1104815760 |
---|---|
Provider Name | William Frederick Kramer |
First Address | Folsom, CA 95630-3315 |
Second Address | Folsom, CA 95630-3315 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2005 |
Last Update Date | 11/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0012436760002 | (05) | PA |
E82600 | (02) |