Provider Demographics
NPI:1598216848
Name:WHITE, RONALD EUGENE
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:EUGENE
Last Name:WHITE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4721 BOYCE DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-4104
Mailing Address - Country:US
Mailing Address - Phone:916-599-0391
Mailing Address - Fax:
Practice Address - Street 1:4721 BOYCE DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-4104
Practice Address - Country:US
Practice Address - Phone:916-599-0391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-21
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program