Individual
DR. RAMIN TAYANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
653 CAMINO DE LOS MARES, STE 107, SAN CLEMENTE, CA 92673
(949) 489-2218
(949) 496-3604
Mailing address
653 CAMINO DE LOS MARES, STE 107, SAN CLEMENTE, CA 92673
(949) 489-2218
(949) 496-3604
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A69679
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A696790
BLUE SHIELD PROVIDER #
CA
05
—
00A696791
—
CA
01
—
330908874
TAX ID#
CA
Enumeration date
10/04/2006
Last updated
08/31/2012
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