Provider Demographics
NPI:1427058395
Name:SALTZMAN, RONALD STANLEY (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:STANLEY
Last Name:SALTZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:657 CAMINO DE LOS MARES
Mailing Address - Street 2:#135
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-2826
Mailing Address - Country:US
Mailing Address - Phone:949-661-7562
Mailing Address - Fax:949-661-7566
Practice Address - Street 1:657 CAMINO DE LOS MARES
Practice Address - Street 2:#135
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-2826
Practice Address - Country:US
Practice Address - Phone:949-661-7562
Practice Address - Fax:949-661-7566
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34907207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A27625Medicare UPIN