Healthcare Provider Details

I. General information

NPI: 1861943938
Provider Name (Legal Business Name): MARIO ALBERTO RAMIREZ RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2016
Last Update Date: 10/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 IMPERIAL HWY BUILDING 100
DOWNEY CA
90242-3456
US

IV. Provider business mailing address

7601 E. IMPERIAL HWY BUILDING 100
DOWNEY CA
90221
US

V. Phone/Fax

Practice location:
  • Phone: 562-385-8264
  • Fax: 562-383-7891
Mailing address:
  • Phone: 562-385-8264
  • Fax: 562-383-7891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number830672
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: