Provider Demographics
NPI:1699759290
Name:STONE, ANTHONY R (MB, FRCSED)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:R
Last Name:STONE
Suffix:
Gender:M
Credentials:MB, FRCSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4860 Y ST
Mailing Address - Street 2:SUITE 3500
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2307
Mailing Address - Country:US
Mailing Address - Phone:916-734-3121
Mailing Address - Fax:916-734-8094
Practice Address - Street 1:4860 Y ST
Practice Address - Street 2:SUITE 3500
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-3121
Practice Address - Fax:916-734-8094
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41866208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A418660Medicaid
CAA29481Medicare UPIN
CA00A418660Medicaid