Provider Demographics
NPI:1225167240
Name:PEREZ, RAMIRO MOISES (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RAMIRO
Middle Name:MOISES
Last Name:PEREZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 ELSWORTH WAY
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-7339
Mailing Address - Country:US
Mailing Address - Phone:916-817-6744
Mailing Address - Fax:
Practice Address - Street 1:1300 E BIDWELL ST STE 105
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3527
Practice Address - Country:US
Practice Address - Phone:916-983-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 55547183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist