Provider Demographics
NPI:1356785505
Name:RAMGREN, AILEEN N (DO)
Entity type:Individual
Prefix:
First Name:AILEEN
Middle Name:N
Last Name:RAMGREN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3880 MURPHY CANYON RD.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4411
Mailing Address - Country:US
Mailing Address - Phone:858-636-4300
Mailing Address - Fax:858-636-4319
Practice Address - Street 1:25485 MEDICAL CENTER DR.
Practice Address - Street 2:SUITE 220
Practice Address - City:MARRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-6927
Practice Address - Country:US
Practice Address - Phone:951-461-9300
Practice Address - Fax:951-461-9399
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A14418208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics