MEDICARE: DR. LEONARD WILLIAM KRAM M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	G24371	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730126509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONARD WILLIAM KRAM M.D.

Provider Business Mailing Address
First Line	:	1521 GREENFIELD AVE
Second Line	:	#202
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-3422
Country	:	US
Telephone Number	:	310-444-0188
Fax Number	:	310-444-0199

Provider Business Practice Location Address
First Line	:	11777 SAN VICENTE BLVD
Second Line	:	#703
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-5011
Country	:	US
Telephone Number	:	310-444-0188
Fax Number	:	310-444-0199

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	07/13/2007

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