Basic Information
Provider Information
NPI: 1598714511
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KRAMER
FirstName: KRISTINA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2637 SHADELANDS DR
Address2:  
City: WALNUT CREEK
State: CA
PostalCode: 945982512
CountryCode: US
TelephoneNumber: 9259326330
FaxNumber: 9259320139
Practice Location
Address1: 2637 SHADELANDS DR
Address2:  
City: WALNUT CREEK
State: CA
PostalCode: 945982512
CountryCode: US
TelephoneNumber: 9259326330
FaxNumber: 9259320139
Other Information
ProviderEnumerationDate: 05/08/2006
LastUpdateDate: 01/25/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001XA79481CAN Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RS0012XA79481CAN Allopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
207RC0200XA79481CAY Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine

ID Information
IDTypeStateIssuerDescription
00A79481005CA MEDICAID
29001528801CAMEDICARE RAIL ROAD BOARDOTHER


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