Organization
RANDALL G. MICHEL, M.D., A MEDICAL CORPORATION
Active
Organization
RANDALL G. MICHEL, M.D., A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL GEORGE MICHEL M.D. (PRESIDENT)
(805) 733-3541
Entity
Organization
Contact information
Practice address
3839 CONSTELLATION RD, STE D, LOMPOC, CA 93436-1466
(805) 733-3541
(805) 733-0502
Mailing address
3839 CONSTELLATION RD, STE D, LOMPOC, CA 93436-1466
(805) 733-3541
(805) 733-0502
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
G35715
CA
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
G35715
CA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
G35715
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G357150
—
CA
Enumeration date
10/18/2006
Last updated
10/13/2007
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