Provider Demographics
NPI:1730104472
Name:WARNELL, RONALD LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:LEE
Last Name:WARNELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7279
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92375-0279
Mailing Address - Country:US
Mailing Address - Phone:909-556-7245
Mailing Address - Fax:888-827-6318
Practice Address - Street 1:537 CAJON ST
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5903
Practice Address - Country:US
Practice Address - Phone:909-556-7245
Practice Address - Fax:888-827-6318
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2013-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG249602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G249600Medicaid
CA00G249600Medicare PIN
CA00G249600Medicaid