Provider Demographics
NPI:1831280726
Name:RAMADAN, AMR H (MD)
Entity Type:Individual
Prefix:DR
First Name:AMR
Middle Name:H
Last Name:RAMADAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 1706
Mailing Address - Street 2:A
Mailing Address - City:BISHOP
Mailing Address - State:CA
Mailing Address - Zip Code:93515-1706
Mailing Address - Country:US
Mailing Address - Phone:760-872-7059
Mailing Address - Fax:760-873-2616
Practice Address - Street 1:153 PIONEER LN
Practice Address - Street 2:A
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514-2557
Practice Address - Country:US
Practice Address - Phone:760-872-7059
Practice Address - Fax:760-873-2616
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-11-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA51610207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A516100Medicaid
CA00A516101Medicare PIN
CA00A516100Medicaid