Healthcare Provider Details

I. General information

NPI: 1568295947
Provider Name (Legal Business Name): DHANVENDRAN RAMAR MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2024
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40886 GOODWIN WAY
MADERA CA
93636-9900
US

IV. Provider business mailing address

8839 N CEDAR AVE STE B4-18
FRESNO CA
93720-1832
US

V. Phone/Fax

Practice location:
  • Phone: 914-703-0096
  • Fax:
Mailing address:
  • Phone: 914-703-0966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DHANVENDRAN RAMAR
Title or Position: CEO
Credential: MD
Phone: 914-703-0966