Provider Demographics
NPI:1396081154
Name:JOHANNES RAMIREZ MD PC
Entity type:Organization
Organization Name:JOHANNES RAMIREZ MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHANNES
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-759-9766
Mailing Address - Street 1:650 HOBSON WAY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-6706
Mailing Address - Country:US
Mailing Address - Phone:805-485-8515
Mailing Address - Fax:805-247-1893
Practice Address - Street 1:650 HOBSON WAY
Practice Address - Street 2:SUITE 201
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-6706
Practice Address - Country:US
Practice Address - Phone:805-485-8515
Practice Address - Fax:805-247-1893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64975207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100504360Medicaid
NV100504360Medicaid
CACT180AMedicare PIN