Provider Demographics
NPI:1861496382
Name:BLUESTONE, RODNEY H (MD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:H
Last Name:BLUESTONE
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 1:436 N BEDFORD DR
Mailing Address - Street 2:STE 303
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4320
Mailing Address - Country:US
Mailing Address - Phone:310-657-2222
Mailing Address - Fax:310-550-0367
Practice Address - Street 1:436 N BEDFORD DR
Practice Address - Street 2:STE 303
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4320
Practice Address - Country:US
Practice Address - Phone:310-657-2222
Practice Address - Fax:310-550-0367
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25147174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24302Medicare UPIN
CAWA25147AMedicare PIN