Provider Demographics
NPI:1568754075
Name:FAMILY DOCTORS RAMANATHAN, PLLC
Entity Type:Organization
Organization Name:FAMILY DOCTORS RAMANATHAN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMANATHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-616-9471
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1726
Mailing Address - Country:US
Mailing Address - Phone:310-474-9809
Mailing Address - Fax:
Practice Address - Street 1:8475 S EASTERN AVE
Practice Address - Street 2:STE 204
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2862
Practice Address - Country:US
Practice Address - Phone:702-616-9471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY DOCTORS RAMANATHAN, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site