Provider Demographics
NPI:1710237847
Name:RAMIREZ, ALEJANDRO (MD)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-2304
Mailing Address - Country:US
Mailing Address - Phone:888-499-9303
Mailing Address - Fax:
Practice Address - Street 1:540 N NELLIS BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-5368
Practice Address - Country:US
Practice Address - Phone:702-459-7424
Practice Address - Fax:702-431-0265
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15963207R00000X
CA174586207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1710237847Medicaid
NVV111161Medicare PIN