Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 95018650 | CA |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 95018650 | CA |
NPI | 1164194676 |
---|---|
Provider Name | Juan Carlos Ramirez |
First Address | Valencia, CA 91354 |
Second Address | Valencia, CA 91354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2021 |
Last Update Date | 03/10/2021 |