MEDICARE: MR. LUIS D L RAMIREZ II

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	106H00000X	Marriage & Family Therapist	MFC49791	CA

General Provider Information

NPI Number	:	1285894642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LUIS D L RAMIREZ II

Provider Business Mailing Address
First Line	:	1672 W. AVE J SUITE 207
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93534-2301
Country	:	US
Telephone Number	:	661-917-9395
Fax Number	:

Provider Business Practice Location Address
First Line	:	1672 W AVENUE J STE 207
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93534-2861
Country	:	US
Telephone Number	:	661-917-9395
Fax Number	:

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

Provider Enumeration Date	:	06/10/2008
Last Update Date	:	04/14/2011

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