Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | A79076 | CA |
NPI | 1093746182 |
---|---|
Provider Name | Ramzi Khalil Deeik |
First Address | Santa Rosa, CA 95405-4558 |
Second Address | Santa Rosa, CA 95405-4558 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 01/07/2014 |