Provider Demographics
NPI:1932262755
Name:RAMCHANDANI, RAM P (MD)
Entity Type:Individual
Prefix:DR
First Name:RAM
Middle Name:P
Last Name:RAMCHANDANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 CATALINA AVE
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-5706
Mailing Address - Country:US
Mailing Address - Phone:562-598-3679
Mailing Address - Fax:
Practice Address - Street 1:2100 E ANAHEIM ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-3408
Practice Address - Country:US
Practice Address - Phone:562-433-7845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA21924208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A219240Medicaid
CAA86464Medicare UPIN
CA00A219240Medicaid