=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144622762
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | OSCAR VLADIMIR RAMOS MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/26/2014
-----------------------------------------------------
Last Update Date | 12/19/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19901 FIRST ST STE 4
-----------------------------------------------------
City | HILMAR
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95324-9099
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-656-8701
-----------------------------------------------------
Fax | 209-656-8704
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 3768
-----------------------------------------------------
City | MERCED
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95344-3768
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-725-7149
-----------------------------------------------------
Fax | 209-726-0134
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 133369
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------