Healthcare Provider Details

I. General information

NPI: 1629305479
Provider Name (Legal Business Name): MICHAEL DUANE STONE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2009
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13100 STUDEBAKER RD
NORWALK CA
90650-2531
US

IV. Provider business mailing address

1680 N FAIR OAKS AVE
PASADENA CA
91103-1642
US

V. Phone/Fax

Practice location:
  • Phone: 562-864-6377
  • Fax:
Mailing address:
  • Phone: 626-798-0884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number20A5348
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number20A5348
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: