Individual
RANDALL A OW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1504 EUREKA RD STE 150, ROSEVILLE, CA 95661-3111
(916) 453-8696
(916) 453-8715
Mailing address
1504 EUREKA RD STE 150, ROSEVILLE, CA 95661-3111
(916) 233-2631
(916) 453-8696
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
G86601
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040017418
RR MEDICARE PIN
CA
Enumeration date
05/24/2005
Last updated
05/15/2026
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