Individual
JACKSON RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
35 CASA ST STE 130, SAN LUIS OBISPO, CA 93405-1887
(805) 541-1422
Mailing address
35 CASA ST STE 130, SAN LUIS OBISPO, CA 93405-1887
(805) 541-1422
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
A202960
CA
Other
Enumeration date
03/28/2020
Last updated
06/14/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us