Healthcare Provider Details

I. General information

NPI: 1811942071
Provider Name (Legal Business Name): ANDREW N. RAMIREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ANDREW RAMIREZ PA-C

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 01/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 RIDGEGATE PARKWAY
LONE TREE CO
80124-9810
US

IV. Provider business mailing address

5763 DEVILS HEAD CT
GOLDEN CO
80403-1069
US

V. Phone/Fax

Practice location:
  • Phone: 720-225-1900
  • Fax: 303-306-7753
Mailing address:
  • Phone: 303-917-6005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA18066
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA0003486
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: