Provider Demographics
NPI:1093839011
Name:ALBRIGHT, RONALD K (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:K
Last Name:ALBRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 CARNATION DR
Mailing Address - Street 2:
Mailing Address - City:FREEDOM
Mailing Address - State:CA
Mailing Address - Zip Code:95019-3132
Mailing Address - Country:US
Mailing Address - Phone:831-722-8125
Mailing Address - Fax:831-722-3694
Practice Address - Street 1:150 CARNATION DR
Practice Address - Street 2:
Practice Address - City:FREEDOM
Practice Address - State:CA
Practice Address - Zip Code:95019-3132
Practice Address - Country:US
Practice Address - Phone:831-722-8125
Practice Address - Fax:831-722-3694
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG318000207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G318000Medicaid
CA390000516OtherRAILROAD MEDICARE
CA00G318000Medicare ID - Type Unspecified
CA00G318000Medicaid