Healthcare Provider Details

I. General information

NPI: 1013868207
Provider Name (Legal Business Name): RONALD W HOLZ MD/PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2026
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 LONGFELLOW RD
MILL VALLEY CA
94941-1592
US

IV. Provider business mailing address

65 LONGFELLOW RD
MILL VALLEY CA
94941-1592
US

V. Phone/Fax

Practice location:
  • Phone: 734-904-5227
  • Fax:
Mailing address:
  • Phone: 734-904-5227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: