Healthcare Provider Details

I. General information

NPI: 1386318103
Provider Name (Legal Business Name): GEORGE ALFRED RAMZI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 COLDWATER CANYON AVE
NORTH HOLLYWOOD CA
91605-5162
US

IV. Provider business mailing address

1921 N BUENA VISTA ST UNIT 107
BURBANK CA
91504-3377
US

V. Phone/Fax

Practice location:
  • Phone: 818-763-8836
  • Fax:
Mailing address:
  • Phone: 188-225-2828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT151402
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: