Provider Demographics
NPI:1407813488
Name:RUMINSON, RONALD R (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:R
Last Name:RUMINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 E FRESNO ST
Mailing Address - Street 2:
Mailing Address - City:DINUBA
Mailing Address - State:CA
Mailing Address - Zip Code:93618-2501
Mailing Address - Country:US
Mailing Address - Phone:559-591-6000
Mailing Address - Fax:559-591-4254
Practice Address - Street 1:166 E FRESNO ST
Practice Address - Street 2:
Practice Address - City:DINUBA
Practice Address - State:CA
Practice Address - Zip Code:93618-2501
Practice Address - Country:US
Practice Address - Phone:559-591-6000
Practice Address - Fax:559-591-4254
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44627207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA44627OtherCA LIC #
CAH34390OtherBLUE CROSS PROV #
CABR1290713OtherDEA #
CAE41517Medicare UPIN