Provider Demographics
NPI:1770687139
Name:STONE, DAVID SIDNEY (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:SIDNEY
Last Name:STONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:SIDNEY
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5565 W LAS POSITAS BLVD
Mailing Address - Street 2:#350
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588
Mailing Address - Country:US
Mailing Address - Phone:925-463-1070
Mailing Address - Fax:925-463-1566
Practice Address - Street 1:5565 W LAS POSITAS BLVD
Practice Address - Street 2:#350
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-5809
Practice Address - Country:US
Practice Address - Phone:925-463-1070
Practice Address - Fax:925-463-1566
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34026207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA040000797OtherRAILROAD MEDICARE
CA00A340260Medicaid
CA00A340260Medicare ID - Type Unspecified
CA00A340260Medicaid