Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 48894 | CA |
NPI | 1063658185 |
---|---|
Provider Name | Adam Ramirez |
First Address | Torrance, CA 90501-5645 |
Second Address | Torrance, CA 90501-5645 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2008 |
Last Update Date | 18/12/2008 |