Healthcare Provider Details

I. General information

NPI: 1275185050
Provider Name (Legal Business Name): MA RAQUEL RAMOS GARCIA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2019
Last Update Date: 07/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 WILSHIRE BLVD
LOS ANGELES CA
90057-3602
US

IV. Provider business mailing address

14802 CRANBROOK AVE
HAWTHORNE CA
90250-8416
US

V. Phone/Fax

Practice location:
  • Phone: 213-484-9934
  • Fax:
Mailing address:
  • Phone: 310-848-8784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number669661
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: