Healthcare Provider Details

I. General information

NPI: 1770897795
Provider Name (Legal Business Name): RAMIN RAM, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2010
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1628 S GRAND AVE
GLENDORA CA
91740-5433
US

IV. Provider business mailing address

308 S ALMONT DR
BEVERLY HILLS CA
90211-3548
US

V. Phone/Fax

Practice location:
  • Phone: 310-276-1252
  • Fax:
Mailing address:
  • Phone: 310-276-1252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAMIN RAM
Title or Position: CEO
Credential: MD
Phone: 310-276-1252