Individual
RONALD J OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4445 MAGNOLIA AVE, RIVERSIDE, CA 92501-4135
(951) 788-3400
(951) 788-3194
Mailing address
PO BOX 15648, SACRAMENTO, CA 95852-0648
(951) 781-2270
(951) 781-2293
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G51511
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009515110
—
CA
05
—
00G515110
—
CA
Enumeration date
08/02/2005
Last updated
06/16/2008
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