Basic Information
Provider Information
NPI: 1730304478
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMOS
FirstName: BERNARD
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: P.O. BOX 8800
Address2:  
City: WASCO
State: CA
PostalCode: 932808800
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 701 SCOFIELD AVE
Address2:  
City: WASCO
State: CA
PostalCode: 932807515
CountryCode: US
TelephoneNumber: 6617588400
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/16/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XA52458CAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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