Provider Demographics
NPI:1609803733
Name:RAM, ASHER (MD)
Entity Type:Individual
Prefix:
First Name:ASHER
Middle Name:
Last Name:RAM
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 1:14547 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-1619
Mailing Address - Country:US
Mailing Address - Phone:818-997-3232
Mailing Address - Fax:818-997-7750
Practice Address - Street 1:14547 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-1619
Practice Address - Country:US
Practice Address - Phone:818-997-3232
Practice Address - Fax:818-997-7750
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA00045553207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A455531Medicaid
CAA45553Medicare PIN
CAE20159Medicare UPIN