Individual
MR. RANDY DALE WILLIAMS I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1800 MOUNT VERNON AVE, BAKERSFIELD, CA 93306-3302
(661) 868-0523
(661) 868-1291
Mailing address
1800 MOUNT VERNON AVE, BAKERSFIELD, CA 93306-3302
(661) 868-0523
(661) 868-1291
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
484762
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
484762
RN LICENSE NUMBER
CA
Enumeration date
08/31/2018
Last updated
08/31/2018
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