Provider Demographics
NPI:1528677259
Name:BOUDREAUXRAMIREZ, ZAYNE EDWARD
Entity type:Individual
Prefix:
First Name:ZAYNE
Middle Name:EDWARD
Last Name:BOUDREAUXRAMIREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ZAYNE
Other - Middle Name:EDWARD
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1556 S SULTANA AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-4238
Mailing Address - Country:US
Mailing Address - Phone:909-418-6923
Mailing Address - Fax:909-418-6937
Practice Address - Street 1:1556 S SULTANA AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-4238
Practice Address - Country:US
Practice Address - Phone:909-418-6923
Practice Address - Fax:909-418-6937
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program