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General NPI Number Information
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NPI Number | 1891534103
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Entity Type | Individual
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Provider Name | JOSE RAMOS
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Gender | Male
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Dates
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Enumeration Date | 05/24/2024
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Last Update Date | 05/24/2024
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Provider Practice Location Address
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Address Line | 1107 S 5TH AVE # 140
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City | YUMA
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State | AZ
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Zip | 85364-3839
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Country | US
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Telephone | 619-831-0437
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Fax | 619-785-3404
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Provider Business Mailing Address
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Address Line | 710 E SAN YSIDRO BLVD STE 128
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City | SAN YSIDRO
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State | CA
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Zip | 92173-3123
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Country | US
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Telephone | 619-831-0437
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Fax | 619-785-3404
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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 | 7373717
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License Number State | ZZ
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