Provider Demographics
NPI:1922649771
Name:BLUESTONE, DANIEL LEWIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:LEWIS
Last Name:BLUESTONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7370 N PALM AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-5782
Mailing Address - Country:US
Mailing Address - Phone:559-228-5408
Mailing Address - Fax:559-224-8461
Practice Address - Street 1:7370 N PALM AVE STE 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-5782
Practice Address - Country:US
Practice Address - Phone:559-228-5408
Practice Address - Fax:559-224-8461
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG561142084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology