Provider Demographics
NPI:1740370238
Name:JONES, RONALD BEVAN (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:BEVAN
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3304 RENNER DRIVE
Mailing Address - Street 2:
Mailing Address - City:FORTUNA
Mailing Address - State:CA
Mailing Address - Zip Code:95540
Mailing Address - Country:US
Mailing Address - Phone:707-725-9383
Mailing Address - Fax:707-725-1140
Practice Address - Street 1:3304 RENNER DR
Practice Address - Street 2:
Practice Address - City:FORTUNA
Practice Address - State:CA
Practice Address - Zip Code:95540-3120
Practice Address - Country:US
Practice Address - Phone:707-725-9383
Practice Address - Fax:707-725-1140
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG39637174400000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0028910Medicaid
CA00G396370Medicare PIN
CAA47892Medicare UPIN