Basic Information
| Provider Information | |||||||||
| NPI: | 1093292393 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RAMEZ GHABOUR DO INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 325 N MAPLE DR # 824 | ||||||||
| Address2: | |||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902103865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7142611665 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8700 BEVERLY BLVD | ||||||||
| Address2: | |||||||||
| City: | WEST HOLLYWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900481804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104233277 | ||||||||
| FaxNumber: | 6618788551 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2018 | ||||||||
| LastUpdateDate: | 07/19/2018 | ||||||||
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| AuthorizedOfficialLastName: | GHABOUR | ||||||||
| AuthorizedOfficialFirstName: | RAMEZ | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3104233277 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | A15670 | CA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | A15670 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.