Individual
CARLOS ALBERTO BANUELOS RAMIREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1448 ALLIUM CT UNIT A, BEAUMONT, CA 92223-3394
(951) 500-7933
Mailing address
1448 ALLIUM CT UNIT A, BEAUMONT, CA 92223-3394
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA64123
CA
Other
Enumeration date
03/12/2024
Last updated
03/12/2024
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