Provider Demographics
NPI:1114252822
Name:RAMIREZ, GABRIEL (PA-C)
Entity Type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:MR
Other - First Name:GABRIEL
Other - Middle Name:
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:10495 W PIPER LN
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-8709
Mailing Address - Country:US
Mailing Address - Phone:805-824-6766
Mailing Address - Fax:
Practice Address - Street 1:180 SIERRA COLLEGE DR
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5768
Practice Address - Country:US
Practice Address - Phone:530-273-9541
Practice Address - Fax:530-271-7036
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20568363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical