Provider Demographics
NPI:1992046536
Name:ENDO TEAM
Entity type:Organization
Organization Name:ENDO TEAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-209-3564
Mailing Address - Street 1:PO BOX 2681
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-1681
Mailing Address - Country:US
Mailing Address - Phone:562-209-3564
Mailing Address - Fax:562-381-7013
Practice Address - Street 1:8237 1/2 STEWART AND GRAY RD
Practice Address - Street 2:#107
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5100
Practice Address - Country:US
Practice Address - Phone:562-209-3564
Practice Address - Fax:562-381-7013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17984305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service