Provider Demographics
NPI:1306959499
Name:STONE, ROBERT D (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:D
Last Name:STONE
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 1:676 E 1ST AVE
Mailing Address - Street 2:SUITE 14
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3547
Mailing Address - Country:US
Mailing Address - Phone:530-895-3884
Mailing Address - Fax:530-343-3030
Practice Address - Street 1:676 E 1ST AVE
Practice Address - Street 2:SUITE 14
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-3547
Practice Address - Country:US
Practice Address - Phone:530-895-3884
Practice Address - Fax:530-343-3030
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA22457207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A224571Medicaid
AR180021131OtherRAILROAD RETIREMENT
CA0475230001OtherDMERC SUPPLIER
CA0475230001OtherDMERC SUPPLIER
CA00A224576Medicare PIN