MEDICARE: DR. XAVIER ANTONIO ORTIZ RAMIREZ DC, QME, CME

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	34549	CA
2	111NX0100X	Occupational Health Chiropractor	34549	CA
3	111NI0013X	Independent Medical Examiner Chiropractor	34549	CA

General Provider Information

NPI Number	:	1043871718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. XAVIER ANTONIO ORTIZ RAMIREZ DC, QME, CME

Provider Business Mailing Address
First Line	:	1636 W ROOSEVELT AVE
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92411-3101
Country	:	US
Telephone Number	:	424-214-8068
Fax Number	:

Provider Business Practice Location Address
First Line	:	1850 S WATERMAN AVE STE C
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92408-2852
Country	:	US
Telephone Number	:	909-479-3699
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2019
Last Update Date	:	03/24/2026

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