Provider Demographics
NPI:1528281607
Name:KREMSKY, STANTON S (MD)
Entity type:Individual
Prefix:DR
First Name:STANTON
Middle Name:S
Last Name:KREMSKY
Suffix:
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 1:10102 BEVERLY DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-5415
Mailing Address - Country:US
Mailing Address - Phone:714-316-8847
Mailing Address - Fax:
Practice Address - Street 1:10102 BEVERLY DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-5415
Practice Address - Country:US
Practice Address - Phone:714-316-8847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
CAG475812085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABG279AOtherPTAN
CABG279AOtherPTAN
CAG47581Medicare PIN