Healthcare Provider Details

I. General information

NPI: 1891767505
Provider Name (Legal Business Name): RONALD E FOLTZ MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 FOWLER WAY SUITE 2
PLACERVILLE CA
95667-5738
US

IV. Provider business mailing address

1000 FOWLER WAY SUITE 2
PLACERVILLE CA
95667-5738
US

V. Phone/Fax

Practice location:
  • Phone: 530-626-0058
  • Fax: 530-626-0092
Mailing address:
  • Phone: 530-626-0058
  • Fax: 530-626-0092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number00G203272
License Number StateCA

VIII. Authorized Official

Name: DR. RONALD E FOLTZ
Title or Position: PRESIDENT
Credential: MD
Phone: 530-626-0058