Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | A25459 | CA |
NPI | 1063523264 |
---|---|
Provider Name | Mr. Jesus G Ramirez |
First Address | Los Angeles, CA 90022-4504 |
Second Address | Los Angeles, CA 90022-4504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 21/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A25459 | (05) | CA |
C35334 | (02) | CA |