# FERNANDO RAVESSOUD, M.D. INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** NONE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295773257
- **Authorized official:** FERNANDO RAVESSOUD M.D. (CFO)
- **Authorized official phone:** (562) 595-5424

## Contact information

- **Practice address:** 3918 LONG BEACH BLVD, SUITE 180, LONG BEACH, CA 90807-2666
- **Practice address phone:** (562) 595-5424
- **Practice address fax:** (562) 595-8927
- **Mailing address:** 3918 LONG BEACH BLVD, SUITE 180, LONG BEACH, CA 90807-2666
- **Mailing address phone:** (562) 595-5424
- **Mailing address fax:** (562) 595-8927

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RR0500X | Rheumatology Physician | — | NULL | — |
| 207RR0500X | Rheumatology Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/03/2006
- **Last updated:** 12/18/2008