Healthcare Provider Details

I. General information

NPI: 1427034115
Provider Name (Legal Business Name): RONALD S KINGSTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 08/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E HARDY STREET CENTINELA HOSPITAL MEDICAL CENTER
INGLEWOOD CA
90301
US

IV. Provider business mailing address

PO BOX 5686
ORANGE CA
92863-5686
US

V. Phone/Fax

Practice location:
  • Phone: 310-673-4660
  • Fax:
Mailing address:
  • Phone: 888-598-8819
  • Fax: 714-571-5055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberG36787
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License NumberG36787
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberG36787
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: