Ricardo Bravo, CNIM
Individual provider Active NPI Electroneurodiagnostic Specialist/Technologist · South Gate, CA
NPI 1801293279 · NPPES record last updated Dec 1, 2014
Key facts
- NPI
- 1801293279
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Electroneurodiagnostic Specialist/Technologist 246ZE0600X
- License
- 201 (CA)
- Practice address
- 9320 McNerney Ave
South Gate, CA 90280-4938 - Phone
- (323) 385-8053
- NPI assigned
- Dec 1, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201 | CA | MD | Electroneurodiagnostic Specialist/Technologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Electroneurodiagnostic Specialist/Technologist | 246ZE0600X | 201 | CA | Yes |
Addresses
Primary practice location
9320 McNerney Ave
South Gate, CA 90280-4938
Mailing address
PO Box 1625
Hawaiian Gardens, CA 90716-1625
Phone (323) 385-8053
Other providers in South Gate, CA
- Nicholas Patrick Blasingame
- Kenneth Bonner
- Yueh-Guei Sheu Book
- Stephanie Boorstin Casasola
- Boone Navath Bou
- Brookdale Medical Center Inc
- Leny Jovana Brotherton
- Emily Byrne
- Lucas Cadena
- Cali Med Corporation
All providers in South Gate, CA · Electroneurodiagnostic Specialist/Technologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.