Provider Demographics
NPI:1922247709
Name:RONALD DAOUD MD INC
Entity Type:Organization
Organization Name:RONALD DAOUD MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:DAOUD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-339-8802
Mailing Address - Street 1:1010 W LA VETA AVE
Mailing Address - Street 2:SUITE 775
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4304
Mailing Address - Country:US
Mailing Address - Phone:707-339-8802
Mailing Address - Fax:714-633-1484
Practice Address - Street 1:1010 W LA VETA AVE
Practice Address - Street 2:SUITE 775
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4304
Practice Address - Country:US
Practice Address - Phone:707-339-8802
Practice Address - Fax:714-633-1484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA51211207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A512110Medicaid
CABD2877263OtherDEA
CA00A512110Medicaid
CAF41070Medicare UPIN