Randall, Russell James

Randall, Russell James is an individual health care provider with primary practice located at 227 Colfax Avenue , Grass Valley CA 95945. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Randall, Russell James can be contacted via phone (530) 273-7988.

Contact Information

Primary practice address
227 Colfax Avenue Grass Valley CA 95945
Phone: (530) 273-7988
Fax: (530) 273-7993
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X DC0109140 California

Profile Details

NPI number 1104988591
LBN Legal business name Randall, Russell James
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2006
Last updated Aug 24th, 2012 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104988591 NPPES
California MEDICAID 0109140

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