Provider Demographics
NPI:1679503940
Name:RAMOS, VENUS (MD)
Entity Type:Individual
Prefix:
First Name:VENUS
Middle Name:
Last Name:RAMOS
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 1:701E 28TH ST 116
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2771
Mailing Address - Country:US
Mailing Address - Phone:562-424-8111
Mailing Address - Fax:562-912-4500
Practice Address - Street 1:701E 28TH ST 116
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2771
Practice Address - Country:US
Practice Address - Phone:562-424-8111
Practice Address - Fax:562-912-4500
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72017208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA72017AMedicare PIN