Healthcare Provider Details

I. General information

NPI: 1568406114
Provider Name (Legal Business Name): RONALD P ENRIQUEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 PARNASSUS AVE FL 4
SAN FRANCISCO CA
94143-2206
US

IV. Provider business mailing address

4347 CITRUS LN
FALLBROOK CA
92028-9860
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-9035
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberC10008527
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberC10008527
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG87219
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: