Healthcare Provider Details

I. General information

NPI: 1811054315
Provider Name (Legal Business Name): BARBARA P RAMOS PA-P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 12/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91275 AVE 66TH 500
MECCA CA
92254
US

IV. Provider business mailing address

1166 K ST
BRAWLEY CA
92227-2737
US

V. Phone/Fax

Practice location:
  • Phone: 760-396-0110
  • Fax:
Mailing address:
  • Phone: 760-344-9951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberPA247710
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: