Healthcare Provider Details

I. General information

NPI: 1497219786
Provider Name (Legal Business Name): JULIE KRAMER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2019
Last Update Date: 01/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3055 W ORANGE AVE STE 207
ANAHEIM CA
92804-3154
US

IV. Provider business mailing address

3055 W ORANGE AVE STE 207
ANAHEIM CA
92804-3154
US

V. Phone/Fax

Practice location:
  • Phone: 714-229-8246
  • Fax:
Mailing address:
  • Phone: 714-229-8246
  • Fax: 949-360-4200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number56409
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: