Provider Demographics
NPI:1699974634
Name:DIZON, CARMINA RAMOS (MD)
Entity type:Individual
Prefix:
First Name:CARMINA
Middle Name:RAMOS
Last Name:DIZON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CARMINA
Other - Middle Name:
Other - Last Name:ARMI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:39400 PASEO PADRE PKWY
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2310
Mailing Address - Country:US
Mailing Address - Phone:661-635-3050
Mailing Address - Fax:661-869-1503
Practice Address - Street 1:815 DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-1365
Practice Address - Country:US
Practice Address - Phone:661-322-3905
Practice Address - Fax:661-322-1370
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA100108207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine