Provider Demographics
NPI:1760651376
Name:DAVID S. STONE MD INC. A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:DAVID S. STONE MD INC. A PROFESSIONAL CORPORATION
Other - Org Name:DAVID S. STONE MD., INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:S
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-463-1070
Mailing Address - Street 1:5565 W LAS POSITAS BLVD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-5809
Mailing Address - Country:US
Mailing Address - Phone:925-463-1070
Mailing Address - Fax:925-463-1566
Practice Address - Street 1:5565 W LAS POSITAS BLVD
Practice Address - Street 2:SUITE 350
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-5809
Practice Address - Country:US
Practice Address - Phone:925-463-1070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34026207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A340260Medicaid
CA040000797OtherRAILROAD MEDICARE
CA00A340260Medicaid
CA040000797OtherRAILROAD MEDICARE