Basic Information
| Provider Information | |||||||||
| NPI: | 1801172291 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CRATER | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21634 RETREAT PKWY | ||||||||
| Address2: | |||||||||
| City: | TEMESCAL VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928836100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9516836370 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 21634 RETREAT PKWY | ||||||||
| Address2: | |||||||||
| City: | TEMESCAL VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928836100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9516836370 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2011 | ||||||||
| LastUpdateDate: | 10/20/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | A118398 | CA | N | Allopathic & Osteopathic Physicians | Surgery | 207X00000X | A118398 | CA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.