Provider Demographics
NPI:1205858677
Name:RAM, ANANT (MD)
Entity Type:Individual
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First Name:ANANT
Middle Name:
Last Name:RAM
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1535 MERCED AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3410
Mailing Address - Country:US
Mailing Address - Phone:626-960-9992
Mailing Address - Fax:626-960-5221
Practice Address - Street 1:1535 MERCED AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3410
Practice Address - Country:US
Practice Address - Phone:626-960-9992
Practice Address - Fax:626-960-5221
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2008-02-26
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Provider Licenses
StateLicense IDTaxonomies
CAA38643207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA38643Medicare ID - Type Unspecified