Provider Demographics
NPI:1528650165
Name:RAMIREZ, RUPERT MARASIGAN (NP)
Entity type:Individual
Prefix:MR
First Name:RUPERT
Middle Name:MARASIGAN
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3353 LAS VEGAS DR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-3809
Mailing Address - Country:US
Mailing Address - Phone:619-764-1214
Mailing Address - Fax:
Practice Address - Street 1:3353 LAS VEGAS DR
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-3809
Practice Address - Country:US
Practice Address - Phone:619-764-1214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016550363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95127972OtherRN LICENSE NUMBER
CA95016550OtherNP LICENSE NUMBER