Provider Demographics
NPI:1669431318
Name:RAMOS, MADELEINE S (MD)
Entity type:Individual
Prefix:DR
First Name:MADELEINE
Middle Name:S
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 1:2773 HARRISON AVE.
Mailing Address - Street 2:STE D
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-3236
Mailing Address - Country:US
Mailing Address - Phone:707-269-9549
Mailing Address - Fax:707-269-9562
Practice Address - Street 1:2773 HARRISON AVE.
Practice Address - Street 2:STE D
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3236
Practice Address - Country:US
Practice Address - Phone:707-269-9549
Practice Address - Fax:707-269-9562
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101471207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168824401Medicaid
I20104Medicare UPIN
8C7491Medicare ID - Type Unspecified