Gray, Randy R
Gray, Randy R is an sole proprietor health care provider with primary practice located at 2550 Sister Mary Columba Dr , Red Bluff CA 96080-4327. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Gray, Randy R can be contacted via phone (530) 528-8701.Contact Information
Primary practice address
2550 Sister Mary Columba Dr
Red Bluff CA 96080-4327
Phone: (530) 528-8701
Fax: (530) 528-8712
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 258 | California |
Profile Details
| NPI number | 1700954070 |
|---|---|
| LBN Legal business name | Gray, Randy R |
| Credentials | Certified Registered Nurse Anesthetist (CRNA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 2nd, 2006 |
| Last updated | Jan 31st, 2014 - 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 | 1700954070 | NPPES |
| California | Other | NA258 | CERTIFIED NURSE ANETHETIS |
| California | MEDICAID | 1700954070 | CERTIFIED NURSE ANETHETIS |
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