Maxey, Randall Whitaker

Maxey, Randall Whitaker is an sole proprietor health care provider with primary practice located at 447 N Prairie Ave , Inglewood CA 90301-1413. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Maxey, Randall Whitaker can be contacted via phone (310) 680-1810.

Contact Information

Primary practice address
447 N Prairie Ave Inglewood CA 90301-1413
Fax: (310) 680-1811
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X C38014 California

Profile Details

NPI number 1700944279
LBN Legal business name Maxey, Randall Whitaker
Credentials MD PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 5th, 2006
Last updated Sep 26th, 2019 - about 5 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 1700944279 NPPES
California MEDICAID 00C380140

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