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General NPI Number Information
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NPI Number | 1043904519
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Entity Type | Individual
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Provider Name | RAMY FARAG
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Gender | Male
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Dates
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Enumeration Date | 06/06/2023
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 6200 EDINGER AVE APT 709
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-8104
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Country | US
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Telephone | 657-502-7996
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Fax |
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Provider Business Mailing Address
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Address Line | 4410 LEONARD WAY
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City | CORONA
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State | CA
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Zip | 92883-0672
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Country | US
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Telephone | 657-502-7996
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DDS111538
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License Number State | CA
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