Provider Demographics
NPI:1316478415
Name:CRAMER, DANIEL I (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:CRAMER
Suffix:I
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPT LA LOCKBOX #24757
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91185-4690
Mailing Address - Country:US
Mailing Address - Phone:833-349-8309
Mailing Address - Fax:
Practice Address - Street 1:1986 COSTA DEL SOL
Practice Address - Street 2:
Practice Address - City:PISMO BEACH
Practice Address - State:CA
Practice Address - Zip Code:93449-3310
Practice Address - Country:US
Practice Address - Phone:530-448-3479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.070087207L00000X
390200000X
CAA172498207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program