Healthcare Provider Details

I. General information

NPI: 1760220511
Provider Name (Legal Business Name): ISAI RAMIREZ PRSS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2024
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 S PRATT AVE
CARSON CITY NV
89701-4730
US

IV. Provider business mailing address

205 S PRATT AVE
CARSON CITY NV
89701-4730
US

V. Phone/Fax

Practice location:
  • Phone: 775-882-3945
  • Fax: 775-882-6126
Mailing address:
  • Phone: 775-882-3945
  • Fax: 775-882-6126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberPRSS-INT-5248
License Number StateNV

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: