Provider Demographics
NPI:1659316412
Name:RAMILO, MARLON GETULIO (MD)
Entity Type:Individual
Prefix:DR
First Name:MARLON
Middle Name:GETULIO
Last Name:RAMILO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1540 FLORIDA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4430
Mailing Address - Country:US
Mailing Address - Phone:209-577-5557
Mailing Address - Fax:207-579-7246
Practice Address - Street 1:1540 FLORIDA AVE STE 100
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4430
Practice Address - Country:US
Practice Address - Phone:209-577-5557
Practice Address - Fax:209-579-7246
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA78835207RC0000X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A788350Medicaid
CAH36608Medicare UPIN
CA00A788350Medicaid