Provider Demographics
NPI:1700899630
Name:RAMIREZ, RUBEN (MD,FACS)
Entity Type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:MD,FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 S ATLANTIC BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-4729
Mailing Address - Country:US
Mailing Address - Phone:626-457-8525
Mailing Address - Fax:626-457-6144
Practice Address - Street 1:850 S ATLANTIC BLVD STE 302
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-4729
Practice Address - Country:US
Practice Address - Phone:626-457-8525
Practice Address - Fax:626-457-6144
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45410208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A45410Medicaid
CAA45410Medicare ID - Type Unspecified
CAE54475Medicare UPIN