Randall, Dennis L
Randall, Dennis L is an individual health care provider with primary practice located at 17100 Euclid Street , Fountain Valley CA 92708. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Randall, Dennis L can be contacted via phone (714) 966-7200.Contact Information
Primary practice address
17100 Euclid Street
Fountain Valley CA 92708
Phone: (714) 966-7200
Fax: (714) 966-8039
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | C28644 | California |
Profile Details
| NPI number | 1396796264 |
|---|---|
| LBN Legal business name | Randall, Dennis L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 15th, 2006 |
| Last updated | Jan 2nd, 2013 - about 11 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 | 1396796264 | NPPES |
| California | Other | 00C286440 | BLUE SHIELD |
| California | MEDICAID | 00C286440 | BLUE SHIELD |
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