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NPI Code Detail

MEDICARE: MINA RAMSIS BOTROS MD

MEDICARE: MINA RAMSIS BOTROS MD
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1124660766
Entity Type Code : Individual
Provider Name (Legal Business Name) : MINA RAMSIS BOTROS MD
Provider Business Mailing Address
First Line : 101 THE CITY DR S
Second Line :
City : ORANGE
State : CA
Zip : 92868-3201
Country : US
Telephone Number : 714-456-6661
Fax Number :
Provider Business Practice Location Address
First Line : 17911 SKY PARK CIR STE E
Second Line :
City : IRVINE
State : CA
Zip : 92614-4303
Country : US
Telephone Number : 949-202-0257
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2019
Last Update Date : 04/07/2026

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Directions to “ MINA RAMSIS BOTROS MD” Practice Location

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