Randall, Jeffrey Blaine

Randall, Jeffrey Blaine is an individual health care provider with primary practice located at 20055 Lake Chabot Rd # 110, Castro Valley CA 94546. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Randall, Jeffrey Blaine can be contacted via phone (510) 886-3138.

Contact Information

Primary practice address
20055 Lake Chabot Rd # 110 Castro Valley CA 94546
Phone: (510) 886-3138
Fax: (510) 373-1616
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X G68717 California

Profile Details

NPI number 1720046295
LBN Legal business name Randall, Jeffrey Blaine
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Dec 28th, 2009 - about 15 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 1720046295 NPPES
California MEDICAID 00G687170

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