Provider Demographics
NPI:1831282300
Name:RAMIREZ, HECTOR GUSTAVO JR (MD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:GUSTAVO
Last Name:RAMIREZ
Suffix:JR
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 1:29833 SANTA MARGARITA PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-3619
Mailing Address - Country:US
Mailing Address - Phone:949-858-8652
Mailing Address - Fax:949-858-0162
Practice Address - Street 1:29833 SANTA MARGARITA PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-3619
Practice Address - Country:US
Practice Address - Phone:949-858-8652
Practice Address - Fax:949-858-0162
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABR0765719207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW11487Medicare ID - Type Unspecified
CAE48074Medicare UPIN