1013460328 NPI number — RAFAEL JOSE RAMOS

Table of content: (NPI 1013460328)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013460328 NPI number — RAFAEL JOSE RAMOS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAFAEL JOSE RAMOS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013460328
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/03/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
888 N SAN MATEO DR APT A409
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN MATEO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94401-2676
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 LAWRENCE EXPY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA CLARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95051-5173
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-851-5300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/03/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RAMOS
Authorized Official First Name:
RAFAEL JOSE
Authorized Official Middle Name:
Authorized Official Title or Position:
CRNA
Authorized Official Telephone Number:
925-726-9578

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  101738 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)