Provider Demographics
NPI:1578530234
Name:RAMIN C JAMM MD LLC
Entity Type:Organization
Organization Name:RAMIN C JAMM MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMIN
Authorized Official - Middle Name:CYRUS
Authorized Official - Last Name:JAMM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-486-8630
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-02
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD9530174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI088219-01Medicaid
HI0000221614OtherHMSA
HI0000221614OtherHMSA
HIH54397Medicare PIN