Healthcare Provider Details

I. General information

NPI: 1427558832
Provider Name (Legal Business Name): PAMELA DEE RATZLAFF RRT-NPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2018
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10833 LE CONTE
LOS ANGELES CA
90095
US

IV. Provider business mailing address

10833 LE CONTE AVE
LOS ANGELES CA
90095-3075
US

V. Phone/Fax

Practice location:
  • Phone: 424-259-8902
  • Fax:
Mailing address:
  • Phone: 424-259-8902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278P3900X
TaxonomyNeonatal/Pediatric Certified Respiratory Therapist
License Number18712
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: