Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | G36787 | CA |
NPI | 1427034115 |
---|---|
Provider Name | Ronald S Kingston |
First Address | Orange, CA 92863-5686 |
Second Address | Inglewood, CA 90301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2005 |
Last Update Date | 15/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G367870 | (05) | CA |
00G367870 | BLUE SHIELD (01) | |
00G367870E02 | CALOPTIMA (01) | |
050739CA46805 | TRAILBLAZER (01) | |
360002841 | RAILROAD MEDICARE (01) | |
A46805 | (02) |