Individual provider Active NPI

Ronald Stanley Bronow

  • Dermatology Physician
  • Sherman Oaks, CA
National Provider Identifier
1366747883
Registry record updated Jan 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
AO19095 Issued in CA
Practice address
3571 Crownridge Dr
Sherman Oaks, CA 91403-4815
Phone
(818) 906-7906
Fax
(818) 906-7908
NPI assigned
Jan 13, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X AO19095 CA Primary

Addresses

Primary practice location

3571 Crownridge Dr
Sherman Oaks, CA 91403-4815

Mailing address

3571 Crownridge Dr
Sherman Oaks, CA 91403-4815
Phone (818) 906-7906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AO19095CAMDDermatology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294876800000",
    "number": "1366747883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3571 CROWNRIDGE DR",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914034815",
            "telephone_number": "818-906-7906",
            "fax_number": "818-906-7908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3571 CROWNRIDGE DR",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914034815",
            "telephone_number": "818-906-7906",
            "fax_number": "818-906-7908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONOW",
        "first_name": "RONALD",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-13",
        "last_updated": "2011-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "AO19095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.