Healthcare Provider Details

I. General information

NPI: 1063831386
Provider Name (Legal Business Name): RON YALON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 01/22/2024
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2675 PLEASANT HILL RD
PLEASANT HILL CA
94523-2033
US

IV. Provider business mailing address

1450 TREAT BLVD # 300
WALNUT CREEK CA
94597-2168
US

V. Phone/Fax

Practice location:
  • Phone: 925-692-5570
  • Fax:
Mailing address:
  • Phone: 925-952-2828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA138748
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: