Healthcare Provider Details

I. General information

NPI: 1679636112
Provider Name (Legal Business Name): ALAN RAMOS NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 LENOX PARK BLVD SUITE 214
MEMPHIS TN
38115-4299
US

IV. Provider business mailing address

222 W 39TH AVE
SAN MATEO CA
94403-4364
US

V. Phone/Fax

Practice location:
  • Phone: 901-273-2368
  • Fax:
Mailing address:
  • Phone: 650-573-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number371484
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: