Individual
DR. SAMUEL RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11234 ANDERSON ST, LLUMC HOUSE STAFF OFFICE CP 21005, LOMA LINDA, CA 92354
(909) 558-1000
Mailing address
11234 ANDERSON ST, LLUMC HOUSE STAFF OFFICE CP 21005, LOMA LINDA, CA 92354
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A97396
CA
Other
Enumeration date
06/05/2007
Last updated
07/08/2007
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