Healthcare Provider Details

I. General information

NPI: 1386798338
Provider Name (Legal Business Name): EVELYN AGUILERA KRAMER P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EVELYN A KRAMER PA

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 08/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

992 O ST
FIREBAUGH CA
93622-2221
US

IV. Provider business mailing address

29121 W WHITESBRIDGE AVE
MENDOTA CA
93640-9702
US

V. Phone/Fax

Practice location:
  • Phone: 559-659-3011
  • Fax: 559-659-3065
Mailing address:
  • Phone: 559-903-0839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA12331
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: