Provider Demographics
NPI:1972328011
Name:RAMIREZ, JORGE FERNANDO (EMT)
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:FERNANDO
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29611 FAIRGLEN CT
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-1207
Mailing Address - Country:US
Mailing Address - Phone:949-289-0833
Mailing Address - Fax:
Practice Address - Street 1:29611 FAIRGLEN CT
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-1207
Practice Address - Country:US
Practice Address - Phone:949-289-0833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE199625146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic