Basic Information
Provider Information
NPI: 1003016023
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MOTARJEMI
FirstName: RAMIN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 232410
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921932410
CountryCode: US
TelephoneNumber: (858) 249-6748
FaxNumber:  
Practice Location
Address1: 200 W ARBOR DR
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921039000
CountryCode: US
TelephoneNumber: 8582492500
FaxNumber: 8586578069
Other Information
ProviderEnumerationDate: 07/18/2007
LastUpdateDate: 09/26/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XA109710CAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RG0300XA109710CAY Allopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
208M00000XA109710CAN Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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