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Organization

PACIFIC BRAIN & SPINE MED GRP INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFREY BLAINE RANDALL MD (PRESIDENT)
(510) 886-3138
Entity
Organization

Contact information

Practice address
20055 LAKE CHABOT RD, # 110, CASTRO VALLEY, CA 94546
(510) 886-3138
(510) 373-1616
Mailing address
20055 LAKE CHABOT RD, # 110, CASTRO VALLEY, CA 94546
(510) 886-3138
(510) 373-1616

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary

Other

Enumeration date
04/27/2006
Last updated
08/22/2020
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