MEDICARE: DR. JOHN FERNANDO RAMOS SR. D.D.S

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	1223G0001X	General Practice Dentistry	D42216	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G93941-01	OTHER	CA	PROVIDER ID

General Provider Information

NPI Number	:	1326190620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN FERNANDO RAMOS SR. D.D.S

Provider Business Mailing Address
First Line	:	34616 COLLIER FALLS CT
Second Line	:
City	:	TEMECULA
State	:	CA
Zip	:	92592-1515
Country	:	US
Telephone Number	:	909-613-1300
Fax Number	:

Provider Business Practice Location Address
First Line	:	5250 PHILADELPHIA ST STE O
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-2483
Country	:	US
Telephone Number	:	909-613-1300
Fax Number	:	909-613-1302

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

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	01/29/2016

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