Provider Demographics
NPI:1063446896
Name:RAMIREZ, JOHANNES (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHANNES
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18519 ROSCOE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4632
Mailing Address - Country:US
Mailing Address - Phone:818-626-8955
Mailing Address - Fax:818-626-9536
Practice Address - Street 1:18519 ROSCOE BLVD
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4632
Practice Address - Country:US
Practice Address - Phone:818-626-8955
Practice Address - Fax:818-626-9536
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64975207V00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100504360Medicaid
NV101717Medicare ID - Type Unspecified
NV100504360Medicaid
CACT180AMedicare PIN