Provider Demographics
NPI:1619198785
Name:EBEID, RAMY HATEM
Entity Type:Individual
Prefix:
First Name:RAMY
Middle Name:HATEM
Last Name:EBEID
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:RAMY
Other - Middle Name:HATEM
Other - Last Name:MOHAMED EBEID
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:330 CRISP AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94592-1126
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2055 SOLANO AVE
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-6456
Practice Address - Country:US
Practice Address - Phone:707-552-1476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57049183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist