Individual
DR. RANDALL FAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
525 E 68TH ST, NEW YORK, NY 10065-4870
(212) 746-4376
Mailing address
1320 YORK AVE, APT 22S, NEW YORK, NY 10021-4800
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
250249-1
NY
207L00000X
Anesthesiology Physician
Primary
A121024
CA
Other
Enumeration date
11/02/2008
Last updated
02/16/2023
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