Provider Demographics
NPI:1043046600
Name:JAUREGUI, RAMON
Entity type:Individual
Prefix:
First Name:RAMON
Middle Name:
Last Name:JAUREGUI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:RAY
Other - Middle Name:
Other - Last Name:JAUREGUI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1030 OAKHORNE DR
Mailing Address - Street 2:
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-1526
Mailing Address - Country:US
Mailing Address - Phone:310-633-3791
Mailing Address - Fax:
Practice Address - Street 1:500 E CARSON PLAZA DR STE 224
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-7337
Practice Address - Country:US
Practice Address - Phone:310-633-3791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator