Provider Demographics
NPI:1669993598
Name:BOSCH RAMIREZ, AGNES MARIE
Entity type:Individual
Prefix:
First Name:AGNES
Middle Name:MARIE
Last Name:BOSCH RAMIREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1187 E HERNDON AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3166
Mailing Address - Country:US
Mailing Address - Phone:595-224-0900
Mailing Address - Fax:559-224-9009
Practice Address - Street 1:1187 E HERNDON AVE STE 106
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3166
Practice Address - Country:US
Practice Address - Phone:559-224-0900
Practice Address - Fax:559-224-9009
Is Sole Proprietor?:No
Enumeration Date:2017-06-30
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR33357207V00000X
CAA173006207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology