Healthcare Provider Details

I. General information

NPI: 1952334385
Provider Name (Legal Business Name): RAMSEY KATAN OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RAMZI KATAN OD

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 06/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28401 DATE PALM DR SUITE B
CATHEDRAL CITY CA
92234-4908
US

IV. Provider business mailing address

28401 DATE PALM DR SUITE B
CATHEDRAL CITY CA
92234-3101
US

V. Phone/Fax

Practice location:
  • Phone: 760-202-7070
  • Fax: 760-202-7556
Mailing address:
  • Phone: 760-202-7070
  • Fax: 760-202-7556

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 Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number11899T
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number11899T
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number11899T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: