Healthcare Provider Details

I. General information

NPI: 1487732327
Provider Name (Legal Business Name): JAIME RAMOS M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 W WASHINGTON BLVD STE 2B
LOS ANGELES CA
90015-3316
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 213-623-2225
  • Fax:
Mailing address:
  • Phone: 702-579-3203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA70955
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: