Provider Demographics
NPI:1295789477
Name:RAMOS, TRYNA MARIE (MD)
Entity type:Individual
Prefix:
First Name:TRYNA
Middle Name:MARIE
Last Name:RAMOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 LOMA VISTA RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-1581
Mailing Address - Country:US
Mailing Address - Phone:805-667-2811
Mailing Address - Fax:805-667-2865
Practice Address - Street 1:138 W MAIN ST
Practice Address - Street 2:SUITE E
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-2584
Practice Address - Country:US
Practice Address - Phone:805-667-2850
Practice Address - Fax:805-652-0708
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76353207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA050394OtherBLUE CROSS
CARHM08608FMedicaid
CA95-1683892OtherOTHER INSURANCE
CARHM18553HMedicaid
CAZZT40394FMedicaid
CARHM08609FMedicaid
CA058553Medicare ID - Type UnspecifiedRH MEDICARE
CA050394Medicare ID - Type UnspecifiedMEDICARE
CAWA76353CMedicare ID - Type UnspecifiedPPIN
CAWA76353AMedicare ID - Type UnspecifiedPPIN
CAWA76353DMedicare ID - Type UnspecifiedPPIN
I03188Medicare UPIN
CAWA76353BMedicare ID - Type UnspecifiedPPIN
CA058609Medicare ID - Type UnspecifiedRH MEDICARE
CAZZT40394FMedicaid