Healthcare Provider Details

I. General information

NPI: 1609964196
Provider Name (Legal Business Name): VICTORIA TAN RAMIREZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USCG HEADQUARTERS CLINIC 2100 SECOND ST. SW ,ROOM B732
WASHINGTON DC
20593-0001
US

IV. Provider business mailing address

USCG HEADQUARTERS CLINIC 2100 SECOND ST. SW ,ROOM B732
WASHINGTON DC
20593-0001
US

V. Phone/Fax

Practice location:
  • Phone: 202-372-4100
  • Fax: 202-372-4910
Mailing address:
  • Phone: 202-372-4100
  • Fax: 202-372-4910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101037236
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA-39916
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-026246-E
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3236
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: