MEDICARE: MR. MIGUEL H RAMIREZ LCSW BCD

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	1041C0700X	Clinical Social Worker	LCSW04535	CA

General Provider Information

NPI Number	:	1174681290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MIGUEL H RAMIREZ LCSW BCD

Provider Business Mailing Address
First Line	:	8730 ALDEN DR
Second Line	:	RM W114
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-3811
Country	:	US
Telephone Number	:	310-423-3567
Fax Number	:	310-423-0114

Provider Business Practice Location Address
First Line	:	8730 ALDEN DR
Second Line	:	RM W114
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-3811
Country	:	US
Telephone Number	:	310-423-3567
Fax Number	:	310-423-0114

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

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	07/08/2007

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