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NPI Code Detail

MEDICARE: DR. RONALD LEE FIRESTONE DC

MEDICARE: DR. RONALD LEE FIRESTONE DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorDC10884CA

General Provider Information

NPI Number : 1366829467
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RONALD LEE FIRESTONE DC
Provider Business Mailing Address
First Line : 24582 DEL PRADO STE H
Second Line :
City : DANA POINT
State : CA
Zip : 92629-3821
Country : US
Telephone Number : 213-514-1905
Fax Number :
Provider Business Practice Location Address
First Line : 24582 DEL PRADO STE H
Second Line :
City : DANA POINT
State : CA
Zip : 92629-3821
Country : US
Telephone Number : 213-514-1905
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2015
Last Update Date : 04/28/2015

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Directions to “ DR. RONALD LEE FIRESTONE DC” Practice Location

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