Provider Demographics
NPI:1942347612
Name:RONALD E. BISHOP MD INC.
Entity Type:Organization
Organization Name:RONALD E. BISHOP MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-781-3789
Mailing Address - Street 1:PO BOX 4858
Mailing Address - Street 2:
Mailing Address - City:PALOS VERDES PENINSULA
Mailing Address - State:CA
Mailing Address - Zip Code:90274-9636
Mailing Address - Country:US
Mailing Address - Phone:310-781-3789
Mailing Address - Fax:310-377-1819
Practice Address - Street 1:880 S ATLANTIC BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-4700
Practice Address - Country:US
Practice Address - Phone:626-289-0178
Practice Address - Fax:626-308-2083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60758207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty