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General NPI Number Information
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NPI Number | 1730958554
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Entity Type | Individual
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Provider Name | EDGAR RAMOS
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Gender | Male
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Dates
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Enumeration Date | 12/20/2023
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 1950 E 17TH ST STE 150
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City | SANTA ANA
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State | CA
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Zip | 92705-6852
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Country | US
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Telephone | 714-844-5588
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Fax |
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Provider Business Mailing Address
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Address Line | 1815 S WESTSIDE DR UNIT 1103
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City | ANAHEIM
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State | CA
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Zip | 92805-8666
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Country | US
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Telephone | 562-536-1475
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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 | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 721461
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License Number State | CA
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