Provider Demographics
NPI:1366603789
Name:BELLINGER, ADAM STONE
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:STONE
Last Name:BELLINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1799 W. YOSEMITE AVENUE
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-5160
Mailing Address - Country:US
Mailing Address - Phone:209-858-7775
Mailing Address - Fax:
Practice Address - Street 1:1799 W. YOSEMITE AVENUE
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-5160
Practice Address - Country:US
Practice Address - Phone:209-858-7775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA123858208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology