Provider Demographics
NPI:1437321593
Name:RICHARD A STONE, M.D., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:RICHARD A STONE, M.D., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-837-9696
Mailing Address - Street 1:PO BOX 2668
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1089
Mailing Address - Country:US
Mailing Address - Phone:760-360-9846
Mailing Address - Fax:760-360-8643
Practice Address - Street 1:39000 BOB HOPE DR STE P103
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-7018
Practice Address - Country:US
Practice Address - Phone:760-837-9696
Practice Address - Fax:760-360-8643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG26862207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G268620Medicaid
CA00G268620Medicaid