Organization
H. RANDALL HICKS, M.D. INC, H RANDALL HICKS PRES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
H. RANDALL HICKS M.D. (PRESIDENT & CEO)
(619) 298-7135
Entity
Organization
Contact information
Practice address
4060 FOURTH AVE, SUITE 615, SAN DIEGO, CA 92103-2116
(619) 298-7135
(858) 874-8837
Mailing address
4060 FOURTH AVE, SUITE 615, SAN DIEGO, CA 92103-2116
(619) 298-7135
(858) 874-8837
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G47439
CA
Other
Enumeration date
11/08/2010
Last updated
03/04/2014
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