Provider Demographics
NPI:1316116890
Name:GEORGIES, RAMI (MD)
Entity type:Individual
Prefix:DR
First Name:RAMI
Middle Name:
Last Name:GEORGIES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 690910
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95269-0910
Mailing Address - Country:US
Mailing Address - Phone:209-472-7400
Mailing Address - Fax:209-472-7474
Practice Address - Street 1:8001 LORRAINE AVE
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210
Practice Address - Country:US
Practice Address - Phone:209-472-7400
Practice Address - Fax:209-472-7474
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102009207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFG0632883OtherDEA