# RANDALL G. MICHEL, M.D., A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477634178
- **Authorized official:** DR. RANDALL GEORGE MICHEL M.D. (PRESIDENT)
- **Authorized official phone:** (805) 733-3541

## Contact information

- **Practice address:** 3839 CONSTELLATION RD, STE D, LOMPOC, CA 93436-1466
- **Practice address phone:** (805) 733-3541
- **Practice address fax:** (805) 733-0502
- **Mailing address:** 3839 CONSTELLATION RD, STE D, LOMPOC, CA 93436-1466
- **Mailing address phone:** (805) 733-3541
- **Mailing address fax:** (805) 733-0502

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | G35715 | CA | — |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | G35715 | CA | Yes |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | G35715 | CA | — |

## Other

- **Enumeration date:** 10/18/2006
- **Last updated:** 10/13/2007