Healthcare Provider Details

I. General information

NPI: 1770609471
Provider Name (Legal Business Name): RICHARD THOMAS STONE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 06/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CONGRESS ST SUITE 407
PASADENA CA
91105-3045
US

IV. Provider business mailing address

10 CONGRESS ST SUITE 407
PASADENA CA
91105-3045
US

V. Phone/Fax

Practice location:
  • Phone: 626-396-9941
  • Fax: 626-396-9586
Mailing address:
  • Phone: 626-396-9941
  • Fax: 626-396-9586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberG29932
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: