MEDICARE: IBRAHIM RAMZY MD

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	207ZP0101X	Anatomic Pathology Physician	000000C50808	CA

General Provider Information

NPI Number	:	1770663916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IBRAHIM RAMZY MD

Provider Business Mailing Address
First Line	:	UCI DEPARTMENT OF PATHOLOGY
Second Line	:	PO BOX 513377
City	:	LOS ANGELES
State	:	CA
Zip	:	90051-3377
Country	:	US
Telephone Number	:	714-456-6369
Fax Number	:

Provider Business Practice Location Address
First Line	:	UCI MEDICAL CENTER
Second Line	:	101 THE CITY DRIVE SOUTH
City	:	ORANGE
State	:	CA
Zip	:	92868
Country	:	US
Telephone Number	:	714-456-8978
Fax Number	:

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

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	07/08/2007

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