Healthcare Provider Details

I. General information

NPI: 1841580545
Provider Name (Legal Business Name): WILLIAM ALBERT STONE JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2011
Last Update Date: 04/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 N JACKSON AVE
SAN JOSE CA
95116-1603
US

IV. Provider business mailing address

2 PIERCE AVE APT 520
SAN JOSE CA
95110-2958
US

V. Phone/Fax

Practice location:
  • Phone: 408-259-5000
  • Fax:
Mailing address:
  • Phone: 847-997-7637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA120260
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: