Individual
RAMIZ FARGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
26520 CACTUS AVE, MORENO VALLEY, CA 92555-3927
(951) 486-5700
(951) 486-5705
Mailing address
PO BOX 7270, MORENO VALLEY, CA 92552-7270
(951) 486-5700
(951) 486-5705
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A63522
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
A63522
CA
207RP1001X
Pulmonary Disease Physician
Primary
A63522
CA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
A63522
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A635220
—
CA
01
—
00A635221
PTAN
CA
Enumeration date
07/04/2006
Last updated
04/18/2015
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