Provider Demographics
NPI:1881799187
Name:RAMIREZ, RAUL (LAC)
Entity type:Individual
Prefix:DR
First Name:RAUL
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:12450 CULVER BLVD
Mailing Address - Street 2:#305
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066
Mailing Address - Country:US
Mailing Address - Phone:310-266-9760
Mailing Address - Fax:310-306-9262
Practice Address - Street 1:78-370 HIGHWAY 111
Practice Address - Street 2:SUITE 180
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253
Practice Address - Country:US
Practice Address - Phone:760-777-8716
Practice Address - Fax:877-013-2772
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC10942171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist