| Roseville Md Inc. | |
|
1098 Sunrise Ave Ste 100 Roseville CA 95661-4469 | |
| (916) 791-7285 | |
| Not Available |
| Full Name | Roseville Md Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1098 Sunrise Ave Ste 100, Roseville, California |
| Authorized Official Name and Position | Paul E. Kramer (OWNER) |
| Authorized Official Contact | 9167917285 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roseville Md Inc. 1098 Sunrise Ave Ste 100 Roseville CA 95661-4469 Ph: (916) 791-7285 | Roseville Md Inc. 1098 Sunrise Ave Ste 100 Roseville CA 95661-4469 Ph: (916) 791-7285 |
| NPI Number | 1952827925 |
|---|---|
| Provider Enumeration Date | 08/21/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 7719248871 |
|---|---|
| Medicare Enrollment ID | O20180306001542 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952827925 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Paul E Kramer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790794048 PECOS PAC ID: 3971685694 Enrollment ID: I20080201000454 |
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