Provider Demographics
NPI:1285640433
Name:RAMOS, WILFREDO R (MD)
Entity Type:Individual
Prefix:
First Name:WILFREDO
Middle Name:R
Last Name:RAMOS
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 1:5301 F ST
Mailing Address - Street 2:SUITE 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:
Practice Address - Street 1:5301 F ST
Practice Address - Street 2:SUITE 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:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84192207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1939275OtherGREAT WEST
CA2579458OtherUNITED HEALTHCARE
CA2851139OtherCIGNA
CA00A841920Medicaid
CAA84192OtherBLUE CROSS
CAMCMG424800OtherWESTERN HEALTH ADVANTAGE
CA112735OtherHEALTH NET
CA90199248OtherPACIFICARE
CA256749OtherINTERPLAN
CA5643345OtherFIRST HEALTH
CA7265757OtherAETNA
CA000810710597OtherPHCS
CA2579458OtherUNITED HEALTHCARE
CAMCMG424800OtherWESTERN HEALTH ADVANTAGE