Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | C42006 | CA |
NPI | 1043215270 |
---|---|
Provider Name | Dr. Ronald A Kass |
First Address | Stockton, CA 95210-6629 |
Second Address | Stockton, CA 95210-6629 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2005 |
Last Update Date | 04/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C420060 | (05) | CA |
A37726 | (02) | CA |