Provider Demographics
NPI:1124118278
Name:STANGER, R JONATHAN (MD)
Entity type:Individual
Prefix:
First Name:R
Middle Name:JONATHAN
Last Name:STANGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ROLAND
Other - Middle Name:J
Other - Last Name:STANGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:50 DOUGLAS DRIVE SUITE 391
Mailing Address - Street 2:HEALTH SERVICES ADMINISTRATION
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553
Mailing Address - Country:US
Mailing Address - Phone:925-957-5429
Mailing Address - Fax:925-957-5401
Practice Address - Street 1:2500 ALHAMBRA AVENUE
Practice Address - Street 2:CONTRA COSTA REGIONAL MEDICAL CENTER AND HEALTH CENTERS
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553
Practice Address - Country:US
Practice Address - Phone:925-370-5110
Practice Address - Fax:925-370-5142
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG40168207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine