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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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