Basic Information
Provider Information
NPI: 1679758544
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMIREZ
FirstName: ADRIANA
MiddleName: M.
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5767 W CENTURY BLVD
Address2: SUITE 400
City: LOS ANGELES
State: CA
PostalCode: 900455631
CountryCode: US
TelephoneNumber: 3108255000
FaxNumber:  
Practice Location
Address1: 100 STEIN PLZ
Address2: 1-340
City: LOS ANGELES
State: CA
PostalCode: 900950001
CountryCode: US
TelephoneNumber: 3108255000
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/09/2008
LastUpdateDate: 12/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207W00000XA110329CAY Allopathic & Osteopathic PhysiciansOphthalmology 

ID Information
IDTypeStateIssuerDescription
00A110329005CA MEDICAID


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