Provider Demographics
NPI:1336554351
Name:RAMIREZ, MANUEL OSWALDO (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:MANUEL
Middle Name:OSWALDO
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:223 W COLE BLVD
Mailing Address - Street 2:
Mailing Address - City:CALEXICO
Mailing Address - State:CA
Mailing Address - Zip Code:92231-9722
Mailing Address - Country:US
Mailing Address - Phone:760-357-2020
Mailing Address - Fax:603-571-0567
Practice Address - Street 1:223 W COLE BLVD
Practice Address - Street 2:
Practice Address - City:CALEXICO
Practice Address - State:CA
Practice Address - Zip Code:92231-9722
Practice Address - Country:US
Practice Address - Phone:760-357-2020
Practice Address - Fax:760-357-1056
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA51736363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant