Healthcare Provider Details

I. General information

NPI: 1174712582
Provider Name (Legal Business Name): DR RAMSEY KATAN, O.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2007
Last Update Date: 10/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31755 DATE PALM DR STE M
CATHEDRAL CITY CA
92234-3101
US

IV. Provider business mailing address

31755 DATE PALM DR STE M
CATHEDRAL CITY CA
92234-3101
US

V. Phone/Fax

Practice location:
  • Phone: 760-202-7070
  • Fax:
Mailing address:
  • Phone: 760-202-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number11899T
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number11899T
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number11899T
License Number StateCA

VIII. Authorized Official

Name: DR. RAMSEY KATAN
Title or Position: OWNER
Credential: O.D.
Phone: 760-202-7070