Provider Demographics
NPI:1699225292
Name:CARRIEL-ATENAS, RAMON
Entity Type:Individual
Prefix:
First Name:RAMON
Middle Name:
Last Name:CARRIEL-ATENAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4272 QUIGLEY AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90713-3327
Mailing Address - Country:US
Mailing Address - Phone:562-857-7272
Mailing Address - Fax:
Practice Address - Street 1:4272 QUIGLEY AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90713-3327
Practice Address - Country:US
Practice Address - Phone:562-857-7272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19468225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist