MEDICARE: RAMSEY ATAYA DPT

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	225100000X	Physical Therapist	297785	CA

General Provider Information

NPI Number	:	1609458215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAMSEY ATAYA DPT

Provider Business Mailing Address
First Line	:	1676 STRONSAY CT
Second Line	:
City	:	FOLSOM
State	:	CA
Zip	:	95630-6224
Country	:	US
Telephone Number	:	916-873-4605
Fax Number	:

Provider Business Practice Location Address
First Line	:	11610 IBERIA PL
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-2407
Country	:	US
Telephone Number	:	858-485-6706
Fax Number	:

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

Provider Enumeration Date	:	04/22/2021
Last Update Date	:	04/22/2021

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