Provider Demographics
NPI:1841424587
Name:RAMOS, BERNARDINO (NP)
Entity Type:Individual
Prefix:
First Name:BERNARDINO
Middle Name:
Last Name:RAMOS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18979 GAULT ST
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-3909
Mailing Address - Country:US
Mailing Address - Phone:818-996-8206
Mailing Address - Fax:
Practice Address - Street 1:18979 GAULT ST
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-3909
Practice Address - Country:US
Practice Address - Phone:818-996-8206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-10
Last Update Date:2009-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA470273363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily