Provider Demographics
NPI:1235284266
Name:JAMM, RAMIN CYRUS (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMIN
Middle Name:CYRUS
Last Name:JAMM
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 1:98 1079 MOANALUA RD
Mailing Address - Street 2:#490
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4723
Mailing Address - Country:US
Mailing Address - Phone:808-486-8630
Mailing Address - Fax:808-488-9180
Practice Address - Street 1:98 1079 MOANALUA RD
Practice Address - Street 2:#490
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4723
Practice Address - Country:US
Practice Address - Phone:808-486-8630
Practice Address - Fax:808-488-9180
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD9530174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1578530234OtherNPI COMPANY NUMBER
HI0221614OtherHMSA PROVIDER NUMBER
HI08821901Medicaid
HIH54397Medicare ID - Type UnspecifiedPROVIDER NUMBER
HI0221614OtherHMSA PROVIDER NUMBER
HIH54398Medicare PIN