Provider Demographics
NPI:1710067806
Name:CELLONA, RONALD C (MD)
Entity Type:Individual
Prefix:
First Name:RONALD C
Middle Name:
Last Name:CELLONA
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 1:1453 BOONE WAY
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-7457
Mailing Address - Country:US
Mailing Address - Phone:714-985-9717
Mailing Address - Fax:
Practice Address - Street 1:1453 BOONE WAY
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-7457
Practice Address - Country:US
Practice Address - Phone:714-985-9717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA000000A75813207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA050089361OtherRR MEDICARE
CA050089361OtherRR MEDICARE