Provider Demographics
NPI:1558645374
Name:RAM, RANA ANN MICHI (DO)
Entity Type:Individual
Prefix:
First Name:RANA ANN
Middle Name:MICHI
Last Name:RAM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:230 PROSPECT PL
Mailing Address - Street 2:SUITE 310
Mailing Address - City:CORONADO
Mailing Address - State:CA
Mailing Address - Zip Code:92118-1978
Mailing Address - Country:US
Mailing Address - Phone:619-522-3722
Mailing Address - Fax:
Practice Address - Street 1:230 PROSPECT PL
Practice Address - Street 2:SUITE 310
Practice Address - City:CORONADO
Practice Address - State:CA
Practice Address - Zip Code:92118-1978
Practice Address - Country:US
Practice Address - Phone:619-437-1388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A13388207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB226392Medicare PIN