Healthcare Provider Details

I. General information

NPI: 1811066210
Provider Name (Legal Business Name): RAMON RESA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 03/29/2024
Certification Date: 03/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

569 W PUTNAM AVE
PORTERVILLE CA
93257-3260
US

IV. Provider business mailing address

PO BOX 580
LEMOORE CA
93245-0580
US

V. Phone/Fax

Practice location:
  • Phone: 559-781-9301
  • Fax: 559-782-7639
Mailing address:
  • Phone: 559-386-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA40400
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: