Provider Demographics
NPI:1720192685
Name:BJARNASON, RONALD V (DO)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:V
Last Name:BJARNASON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1179
Mailing Address - Street 2:
Mailing Address - City:HILMAR
Mailing Address - State:CA
Mailing Address - Zip Code:95324-0179
Mailing Address - Country:US
Mailing Address - Phone:209-669-2655
Mailing Address - Fax:209-669-2657
Practice Address - Street 1:8397 N LANDER AVE
Practice Address - Street 2:
Practice Address - City:HILMAR
Practice Address - State:CA
Practice Address - Zip Code:95324-0179
Practice Address - Country:US
Practice Address - Phone:209-669-2655
Practice Address - Fax:209-669-2657
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A5161207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX51611Medicaid
CA020A51610Medicare ID - Type Unspecified
CA00AX51611Medicaid