Healthcare Provider Details

I. General information

NPI: 1861187411
Provider Name (Legal Business Name): JUAN MANUEL RAMOS JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 SOQUEL DR
SANTA CRUZ CA
95065-1705
US

IV. Provider business mailing address

1555 SOQUEL DR
SANTA CRUZ CA
95065-1705
US

V. Phone/Fax

Practice location:
  • Phone: 831-462-7296
  • Fax: 360-449-2735
Mailing address:
  • Phone: 831-462-7296
  • Fax: 415-591-6478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: