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General NPI Number Information
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NPI Number | 1720208481
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Entity Type | Organization
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Legal Business Name | RONALD C. ALLISON M.D. INC.
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 03/06/2008
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Provider Practice Location Address
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Address Line | 415 E HARDING WAY STE H
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City | STOCKTON
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State | CA
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Zip | 95204-6118
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Country | US
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Telephone | 209-943-2107
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Fax | 209-943-1048
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Provider Business Mailing Address
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Address Line | 415 E HARDING WAY STE H
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City | STOCKTON
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State | CA
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Zip | 95204-6118
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Country | US
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Telephone | 209-943-2107
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Fax | 209-943-1048
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Authorized Official
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Title or Position | OWNER
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Name | DR. RONALD C. ALLISON
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Credential | M.D.
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Telephone | 209-943-2107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G15360
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License Number State | CA
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