Healthcare Provider Details

I. General information

NPI: 1851022701
Provider Name (Legal Business Name): MARIA VICTORIA RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2022
Last Update Date: 06/21/2022
Certification Date: 06/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 BARSTOW RD
BARSTOW CA
92311-4944
US

IV. Provider business mailing address

15732 MINT ST
ADELANTO CA
92301-4593
US

V. Phone/Fax

Practice location:
  • Phone: 760-252-3502
  • Fax:
Mailing address:
  • Phone: 213-258-8787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberTCH12827
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: