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NPI Code Detail

MEDICARE: MICHAEL EDWIN CRAMER

MEDICARE: MICHAEL EDWIN CRAMER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1568594430
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL EDWIN CRAMER
Provider Business Mailing Address
First Line : 763 W DIKE ST
Second Line :
City : GLENDORA
State : CA
Zip : 91740-4940
Country : US
Telephone Number : 626-857-0500
Fax Number :
Provider Business Practice Location Address
First Line : 23701 E EAST FORK RD
Second Line :
City : AZUSA
State : CA
Zip : 91702-1477
Country : US
Telephone Number : 626-910-1202
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2007
Last Update Date : 09/11/2025

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