Provider Demographics
NPI:1962422436
Name:ALBA, RAMON R (DO)
Entity type:Individual
Prefix:DR
First Name:RAMON
Middle Name:R
Last Name:ALBA
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Gender:M
Credentials:DO
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Mailing Address - Street 1:6528 W INDIAN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85033-3329
Mailing Address - Country:US
Mailing Address - Phone:623-846-3186
Mailing Address - Fax:623-846-3757
Practice Address - Street 1:6528 W INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85033-3329
Practice Address - Country:US
Practice Address - Phone:623-846-3186
Practice Address - Fax:623-846-3757
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2013-11-12
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Provider Licenses
StateLicense IDTaxonomies
AZ1209207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0064310OtherBCBS PROVIDER NUMBER
AZE44448Medicare UPIN