Shue, Randall G
Shue, Randall G is an individual health care provider with primary practice located at 4055 E Olympic Blvd Ste 210, Los Angeles CA 90023-3345. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Shue, Randall G can be contacted via phone (323) 268-3491.Contact Information
Primary practice address
4055 E Olympic Blvd Ste 210
Los Angeles CA 90023-3345
Phone: (323) 268-3491
Fax: (323) 264-8406
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 20A5142 | California |
Profile Details
| NPI number | 1679576730 |
|---|---|
| LBN Legal business name | Shue, Randall G |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2005 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1679576730 | NPPES |
| California | MEDICAID | 00AX51420 | |
| California | MEDICAID | 00AX51422 |
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