Provider Demographics
NPI:1891767505
Name:RONALD E FOLTZ MD INC
Entity Type:Organization
Organization Name:RONALD E FOLTZ MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:FOLTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-626-0058
Mailing Address - Street 1:1000 FOWLER WAY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-5738
Mailing Address - Country:US
Mailing Address - Phone:530-626-0058
Mailing Address - Fax:530-626-0092
Practice Address - Street 1:1000 FOWLER WAY
Practice Address - Street 2:SUITE 2
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-5738
Practice Address - Country:US
Practice Address - Phone:530-626-0058
Practice Address - Fax:530-626-0092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-06
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00G203272207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ05967ZOtherPPO HMO
CAZZZ05967ZOtherBLUE SHIELD
CAZZZ05967ZMedicaid
058518OtherEYEMED
CAZZZ05967ZOtherWORKERS COMP
CAZZZ05967ZMedicaid
058518OtherEYEMED
CAZZZ05967ZMedicaid
=========OtherFEDERAL