Organization
RANDALL MAXEY, MD, CORP
Active
Parent organization
RANDALL MAXEY, MD, CORP
Organization subpart
Yes
Provider details
NPI number
Legal business name
RANDALL MAXEY, MD, CORP
Authorized official
RANDALL MAXEY MD (PRESIDENT)
(310) 680-1810
Entity
Organization
Contact information
Practice address
323 N PRAIRIE AVE, STE 417, INGLEWOOD, CA 90301-4502
(310) 680-1810
Mailing address
2980 N BEVERLY GLEN CIR, STE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
08/18/2010
Last updated
03/01/2011
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