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General NPI Number Information
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NPI Number | 1356057343
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Entity Type | Individual
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Provider Name | DOUG STONE NP
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Gender | Male
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Dates
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Enumeration Date | 01/24/2023
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 11386 PLEASANT VALLEY RD
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City | PENN VALLEY
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State | CA
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Zip | 95946-9000
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Country | US
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Telephone | 530-451-6234
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Fax | 844-543-6123
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Provider Business Mailing Address
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Address Line | 4944 WINDPLAY DR STE 112
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-9310
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Country | US
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Telephone | 202-309-9677
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 95023990
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License Number State | CA
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