Healthcare Provider Details

I. General information

NPI: 1336603901
Provider Name (Legal Business Name): KRAMER SATORU WONG RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2019
Last Update Date: 01/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 CALIFORNIA ST
ESCALON CA
95320-1804
US

IV. Provider business mailing address

6200 N POINT WAY
SACRAMENTO CA
95831-1066
US

V. Phone/Fax

Practice location:
  • Phone: 209-838-3524
  • Fax:
Mailing address:
  • Phone: 916-622-8988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number80028
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: