Coriell, Randall E

Coriell, Randall E is an individual health care provider with primary practice located at 7000 Boulder Ave , Highland CA 92346-3348. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Coriell, Randall E can be contacted via phone (909) 862-1191.

Contact Information

Primary practice address
7000 Boulder Ave Highland CA 92346-3348
Fax: (909) 796-4158
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X G45041 California

Profile Details

NPI number 1912931056
LBN Legal business name Coriell, Randall E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Feb 28th, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912931056 NPPES
California MEDICAID 00G450410

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