Provider Demographics
NPI:1043442122
Name:WILFREDO R RAMOS MD, INC
Entity Type:Organization
Organization Name:WILFREDO R RAMOS MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:WILFREDO
Authorized Official - Middle Name:R
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-453-3440
Mailing Address - Street 1:5301 F ST
Mailing Address - Street 2:STE#210
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-3226
Mailing Address - Country:US
Mailing Address - Phone:916-453-3440
Mailing Address - Fax:916-453-3441
Practice Address - Street 1:5301 F ST
Practice Address - Street 2:STE#210
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3226
Practice Address - Country:US
Practice Address - Phone:916-453-3440
Practice Address - Fax:916-453-3441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84192207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A841920Medicaid
CA2579458OtherUNITED HEALTHCARE
CA2851139OtherCIGNA
CA000810710597OtherPHCS
CA256749OtherINTERPLAN
CA90199248OtherPACIFICARE
CA1939275OtherGREAT WEST
CA5643345OtherFIRST HEALTH
CA112735OtherHEALTH NET
CA7265757OtherAETNA
CAA84192OtherBLUE CROSS
CAMCMG424800OtherWESTERN HEALTH ADVANTAGE
CA2851139OtherCIGNA
CA1939275OtherGREAT WEST