MEDICARE: CATHERINE RAMOS MARIN NURSE PRACTITIONER

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	363L00000X	Nurse Practitioner	NP15160	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NP15160	OTHER	CA	NURSE PRACTITIONER

General Provider Information

NPI Number	:	1205943040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE RAMOS MARIN NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	220 AVENUE C
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90277
Country	:	US
Telephone Number	:	310-487-1852
Fax Number	:

Provider Business Practice Location Address
First Line	:	3112 W. BEVERLY BLVD
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640
Country	:	US
Telephone Number	:	323-726-3868
Fax Number	:	323-726-3870

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

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	07/08/2007

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