Provider Demographics
NPI:1437476629
Name:J RAMIREZ MEDICAL CORP
Entity Type:Organization
Organization Name:J RAMIREZ MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:G
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-721-5158
Mailing Address - Street 1:6128 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-4504
Mailing Address - Country:US
Mailing Address - Phone:323-721-5158
Mailing Address - Fax:323-721-4148
Practice Address - Street 1:6128 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-4504
Practice Address - Country:US
Practice Address - Phone:323-721-5158
Practice Address - Fax:323-721-4148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-27
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25459261QM1300X, 261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A25459Medicaid
CADN270AOtherMEDICARE PTAN
CAA25459OtherMEDICARE PTAN
CA00A25459Medicaid