Individual provider Active NPI

Marc E Kramer, MD

  • Otolaryngology Physician
  • San Diego, CA
National Provider Identifier
1144320599
Registry record updated Jan 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G48066 Issued in CA
Practice address
8929 University Center Lane
#208
San Diego, CA 92122
Phone
(858) 457-1971
Fax
(858) 457-0049
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X G48066 CA Primary

Addresses

Primary practice location

8929 University Center Lane
#208
San Diego, CA 92122

Mailing address

8929 University Center Lane
#208
San Diego, CA 92122
Phone (858) 457-1971

Other identifiers 1

IdentifierTypeStateIssuer
00G480660MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080520000873 CA Practitioner - Otolaryngology 5597834234 Practice locations: San Diego, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G48066CAMDOtolaryngology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199318400000",
    "number": "1144320599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8929 UNIVERSITY CENTER LANE",
            "address_2": "#208",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92122",
            "telephone_number": "858-457-1971",
            "fax_number": "858-457-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8929 UNIVERSITY CENTER LANE",
            "address_2": "#208",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92122",
            "telephone_number": "858-457-1971",
            "fax_number": "858-457-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAMER",
        "first_name": "MARC",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G48066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G480660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.