Individual provider Active NPI

Mark Steven Cramer, M. D.

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1396860144
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G36434 Issued in CA
Practice address
3581 Millikin Ave
San Diego, CA 92122-2926
Phone
(858) 450-9523
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G36434 CA Primary

Addresses

Primary practice location

3581 Millikin Ave
San Diego, CA 92122-2926

Mailing address

3581 Millikin Ave
San Diego, CA 92122-2926
Phone (858) 450-9523

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
I20160229001780 CA Order and Referring Only - Family PracticePractitioner - Family Practice 6103121132

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36434CAMDGeneral Practice Dentistry
G36434CAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396860144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3581 MILLIKIN AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921222926",
            "telephone_number": "858-450-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3581 MILLIKIN AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921222926",
            "telephone_number": "858-450-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAMER",
        "first_name": "MARK",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G36434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.