Healthcare Provider Details

I. General information

NPI: 1235902396
Provider Name (Legal Business Name): IANN BARRANTES-RAMIREZ CNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2023
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 N SYCAMORE AVE APT 23
LOS ANGELES CA
90036-2645
US

IV. Provider business mailing address

309 N SYCAMORE AVE APT 23
LOS ANGELES CA
90036-2645
US

V. Phone/Fax

Practice location:
  • Phone: 424-421-4344
  • Fax: 360-334-9955
Mailing address:
  • Phone: 424-421-4344
  • Fax: 360-334-9955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberY9346486
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License NumberY9346486
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: