Healthcare Provider Details

I. General information

NPI: 1508955519
Provider Name (Legal Business Name): JESUS SALVADOR RAMIREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 E AVENIDA DE LA MERCED
MONTEBELLO CA
90640-2752
US

IV. Provider business mailing address

9260 PICO VISTA RD
DOWNEY CA
90240-2523
US

V. Phone/Fax

Practice location:
  • Phone: 213-722-7262
  • Fax:
Mailing address:
  • Phone: 562-869-9622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: