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Individual

GUSTAVO RAMOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.-C

Contact information

Practice address
400 W 30TH ST, LOS ANGELES, CA 90007-3320
(213) 284-3200
Mailing address
30141 ANTELOPE RD # D-329, MENIFEE, CA 92584-8066
(951) 227-1155

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA15277
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PA15277
CA
Enumeration date
06/14/2007
Last updated
10/03/2013
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