Healthcare Provider Details

I. General information

NPI: 1962640508
Provider Name (Legal Business Name): RONNIE EUGENE STONE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2009
Last Update Date: 02/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1835 PRAIRIE CITY RD SUITE #200
FOLSOM CA
95630-9582
US

IV. Provider business mailing address

1835 PRAIRIE CITY RD SUITE #200
FOLSOM CA
95630-9582
US

V. Phone/Fax

Practice location:
  • Phone: 916-351-9457
  • Fax: 916-351-9852
Mailing address:
  • Phone: 916-351-9457
  • Fax: 916-351-9852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License NumberG42365
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: