Provider Demographics
NPI:1316962335
Name:KRAMER, W DAMIAN (DO)
Entity type:Individual
Prefix:
First Name:W
Middle Name:DAMIAN
Last Name:KRAMER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2050 S BLOSSER RD
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-7310
Mailing Address - Country:US
Mailing Address - Phone:805-361-8028
Mailing Address - Fax:805-361-8097
Practice Address - Street 1:1057 E GRAND AVE
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-2504
Practice Address - Country:US
Practice Address - Phone:805-481-7220
Practice Address - Fax:805-481-7097
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A5234207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW1508COtherPTAN, BK832W
CAW1508OtherPTAN, BK832Z
CAW1508DOtherPTAN, BK832V
CAW1508EOtherPTAN, BK832X
CAW1508AOtherPTAN, BK832Y
CAFHC70693FMedicaid
CAW1508AOtherPTAN, BK832Y
CAW1508EOtherPTAN, BK832X