Provider Demographics
NPI:1710714407
Name:RAMIREZ, JOSE EMMANUEL
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:EMMANUEL
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 N ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-1804
Mailing Address - Country:US
Mailing Address - Phone:213-613-0630
Mailing Address - Fax:
Practice Address - Street 1:49869 CALHOUN ST
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-9720
Practice Address - Country:US
Practice Address - Phone:760-399-4526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker