Provider Demographics
NPI:1851429617
Name:MASTER, RAMONA (MD)
Entity type:Individual
Prefix:
First Name:RAMONA
Middle Name:
Last Name:MASTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4180 LA JOLLA VILLAGE DR STE 220
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1471
Mailing Address - Country:US
Mailing Address - Phone:858-321-2150
Mailing Address - Fax:858-321-2153
Practice Address - Street 1:4180 LA JOLLA VILLAGE DR STE 220
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1471
Practice Address - Country:US
Practice Address - Phone:858-321-2150
Practice Address - Fax:858-321-2153
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55108207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG47348Medicare UPIN