Blake, Randall Charles
Blake, Randall Charles is an sole proprietor health care provider with primary practice located at 1329 Lusitana St Suite 602, Honolulu HI 96813-2429. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Blake, Randall Charles can be contacted via phone (808) 522-5055.Contact Information
Primary practice address
1329 Lusitana St Suite 602
Honolulu HI 96813-2429
Phone: (808) 522-5055
Fax: (808) 524-6306
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 14192 | Hawaii |
Profile Details
| NPI number | 1447226055 |
|---|---|
| LBN Legal business name | Blake, Randall Charles |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 23rd, 2006 |
| Last updated | Jun 28th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447226055 | NPPES |
| Indiana | MEDICAID | 100171930A |
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