Healthcare Provider Details

I. General information

NPI: 1689618217
Provider Name (Legal Business Name): JONAH LEE KRAMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DR. JONATHAN LEE KRAMER

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 HARRISON ST 7TH FLOOR, TPMG HUMAN RESOURCES, ATT: JAQUELYN QUINN
OAKLAND CA
94612-3466
US

IV. Provider business mailing address

1800 HARRISON ST 7TH FLOOR, TPMG HUMAN RESOURCES, ATT: JAQUELYN QUINN
OAKLAND CA
94612-3466
US

V. Phone/Fax

Practice location:
  • Phone: 510-625-6262
  • Fax:
Mailing address:
  • Phone: 510-625-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG69746
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: