Healthcare Provider Details

I. General information

NPI: 1255302493
Provider Name (Legal Business Name): MARK KROMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 02/16/2023
Certification Date: 02/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 STOCKTON BLVD SURGERY HOUSESTAFF OFFICE ROOM 6309
SACRAMENTO CA
95817-2201
US

IV. Provider business mailing address

330 BORTHWICK AVE STE 308
PORTSMOUTH NH
03801-7112
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-2724
  • Fax:
Mailing address:
  • Phone: 603-334-6260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number16915
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number16915
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: