Provider Demographics
NPI:1770536443
Name:RAMO, VICENTE SEPARA JR (MD)
Entity type:Individual
Prefix:DR
First Name:VICENTE
Middle Name:SEPARA
Last Name:RAMO
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:634 KALIHI ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-4000
Mailing Address - Country:US
Mailing Address - Phone:808-841-7288
Mailing Address - Fax:808-841-8841
Practice Address - Street 1:634 KALIHI ST
Practice Address - Street 2:SUITE 201
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-4000
Practice Address - Country:US
Practice Address - Phone:808-841-7288
Practice Address - Fax:808-841-8841
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2010-03-23
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Provider Licenses
StateLicense IDTaxonomies
HI10117207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1639223209OtherCORPORATION NPI
HI08922003Medicaid
F73793Medicare UPIN
HI1639223209OtherCORPORATION NPI