Basic Information
Provider Information
NPI: 1508285933
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMIREZ
FirstName: MAGDA
MiddleName: LILIAN
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: MSC 11 6025
Address2: 1 UNIVERSITY OF NEW MEXICO
City: ALBUQUERQUE
State: NM
PostalCode: 871310001
CountryCode: US
TelephoneNumber: 5052726607
FaxNumber: 5052728045
Practice Location
Address1: 202 W WILLOW AVE
Address2:  
City: VISALIA
State: CA
PostalCode: 932916238
CountryCode: US
TelephoneNumber: 5052726607
FaxNumber: 5052728045
Other Information
ProviderEnumerationDate: 04/14/2014
LastUpdateDate: 05/03/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XA153100CAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


Home