Basic Information
| Provider Information | |||||||||
| NPI: | 1730477829 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RAMIN POOYAN DO INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1180 N INDIAN CANYON DR | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | PALM SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922624800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603236511 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1180 N INDIAN CANYON DR | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | PALM SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922624800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603236511 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2011 | ||||||||
| LastUpdateDate: | 07/11/2011 | ||||||||
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| AuthorizedOfficialLastName: | POOYAN | ||||||||
| AuthorizedOfficialFirstName: | RAMIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7603236511 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XS0106X | 20A11219 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery |
No ID Information.