Provider Demographics
NPI:1538528963
Name:RONALD R. WARD, M.D., F.A.C.S.
Entity type:Organization
Organization Name:RONALD R. WARD, M.D., F.A.C.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTOLARYNGOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:ROGER
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-385-9848
Mailing Address - Street 1:1000 MAGNOLIA AVE STE A
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1016
Mailing Address - Country:US
Mailing Address - Phone:415-385-9848
Mailing Address - Fax:415-409-5334
Practice Address - Street 1:1000 MAGNOLIA AVE STE A
Practice Address - Street 2:
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1016
Practice Address - Country:US
Practice Address - Phone:415-385-9848
Practice Address - Fax:415-409-5334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-13
Last Update Date:2016-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG30748261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA44533OtherUPIN
CABT446AMedicare PIN