Provider Demographics
NPI:1962475764
Name:STONE, RICHARD A (DPM)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:STONE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1720 MARCO POLO WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-4512
Mailing Address - Country:US
Mailing Address - Phone:650-692-4778
Mailing Address - Fax:650-692-1188
Practice Address - Street 1:1720 MARCO POLO WAY
Practice Address - Street 2:SUITE A
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4512
Practice Address - Country:US
Practice Address - Phone:650-692-4778
Practice Address - Fax:650-692-1188
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE2458213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1200180001OtherNORIDAIN MEDICARE DME