MEDICARE: JEROME RAMSEY

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	1710I1002X	Independent Duty Corpsman

General Provider Information

NPI Number	:	1184095655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEROME RAMSEY

Provider Business Mailing Address
First Line	:	UNIT 100338 BOX NUMBER 1 FPO AE 96693
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92136-0001
Country	:	US
Telephone Number	:	219-680-6081
Fax Number	:

Provider Business Practice Location Address
First Line	:	2534 TRIDENT WAY
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92155-5493
Country	:	US
Telephone Number	:	619-437-2544
Fax Number	:

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

Provider Enumeration Date	:	10/09/2015
Last Update Date	:	04/04/2023

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Directions to “ JEROME RAMSEY ” Practice Location

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