Provider Demographics
NPI:1063934313
Name:RAM, LEOR (MA)
Entity type:Individual
Prefix:MR
First Name:LEOR
Middle Name:
Last Name:RAM
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 N SWALL DR APT 402
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-3039
Mailing Address - Country:US
Mailing Address - Phone:310-775-1313
Mailing Address - Fax:
Practice Address - Street 1:360 N BEDFORD DR STE 219
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5124
Practice Address - Country:US
Practice Address - Phone:310-271-2275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-07
Last Update Date:2017-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist