Healthcare Provider Details

I. General information

NPI: 1255794889
Provider Name (Legal Business Name): PREM NARAYAN RAMKUMAR M.D., M.B.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2016
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 DOWNEY AVE STE 308
DOWNEY CA
90712-1482
US

IV. Provider business mailing address

PO BOX 15848
NEWPORT BEACH CA
92659-5848
US

V. Phone/Fax

Practice location:
  • Phone: 562-633-3787
  • Fax: 562-633-1977
Mailing address:
  • Phone: 657-241-3600
  • Fax: 657-241-7708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA180372
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: