Basic Information
Provider Information
NPI: 1033484233
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMOS
FirstName: JULIA
MiddleName: GOODNOUGH
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
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Mailing Information
Address1: 757 WESTWOOD PLZ
Address2: SUITE 7501, DEPARTMENT OF MEDICINE, RRUMC
City: LOS ANGELES
State: CA
PostalCode: 900957417
CountryCode: US
TelephoneNumber: 3108257375
FaxNumber:  
Practice Location
Address1: 757 WESTWOOD PLZ
Address2: SUITE 7501, DEPARTMENT OF MEDICINE, RRUMC
City: LOS ANGELES
State: CA
PostalCode: 900957417
CountryCode: US
TelephoneNumber: 3108257375
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/20/2012
LastUpdateDate: 08/11/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X127859CAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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