MEDICARE: DR. GARY DONALD STONE M.D.

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
1	207RN0300X	Nephrology Physician	A21111	CA

General Provider Information

NPI Number	:	1992986061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY DONALD STONE M.D.

Provider Business Mailing Address
First Line	:	35653 ROSEMONT DR
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-2762
Country	:	US
Telephone Number	:	760-772-9626
Fax Number	:	760-772-8685

Provider Business Practice Location Address
First Line	:	35653 ROSEMONT DR
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-2762
Country	:	US
Telephone Number	:	760-772-9626
Fax Number	:	760-772-8685

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2007
Last Update Date	:	11/16/2007

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