Provider Demographics
NPI:1609981943
Name:RAMIREZ, CARLOS JR (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:
Last Name:RAMIREZ
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3420 COACH LANE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682
Mailing Address - Country:US
Mailing Address - Phone:530-677-0224
Mailing Address - Fax:530-677-0422
Practice Address - Street 1:3420 COACH LANE
Practice Address - Street 2:SUITE 2
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682
Practice Address - Country:US
Practice Address - Phone:530-677-0224
Practice Address - Fax:530-677-0422
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG347180207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A46044Medicare UPIN
00G347180Medicare ID - Type Unspecified