Provider Demographics
NPI:1609964196
Name:RAMIREZ, VICTORIA TAN (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:TAN
Last Name:RAMIREZ
Suffix:
Gender:F
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:USCG HEADQUARTERS CLINIC
Mailing Address - Street 2:2100 SECOND ST. SW ,ROOM B732
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20593-0001
Mailing Address - Country:US
Mailing Address - Phone:202-372-4100
Mailing Address - Fax:202-372-4910
Practice Address - Street 1:USCG HEADQUARTERS CLINIC
Practice Address - Street 2:2100 SECOND ST. SW ,ROOM B732
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20593-0001
Practice Address - Country:US
Practice Address - Phone:202-372-4100
Practice Address - Fax:202-372-4910
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101037236207Q00000X
CAA-39916207Q00000X
PAMD-026246-E207Q00000X
AK3236207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKG09053Medicare UPIN