Organization
RANDY P. HAUSTED M.D. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY P HAUSTED M.D. (OWNER/ PATHOLOGIST)
(707) 963-6288
Entity
Organization
Contact information
Practice address
10 WOODLAND RD, ST. HELENA, CA 94574-9554
(707) 963-6288
(707) 967-5684
Mailing address
PO BOX 270067, SAINT LOUIS, MO 63127-0067
(707) 241-8205
(314) 856-0635
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G854360
—
CA
05
—
00G854361
—
CA
Enumeration date
09/09/2005
Last updated
08/05/2014
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