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Individual

RANDELL VALLERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
568 N SUNRISE AVE STE 330, ROSEVILLE, CA 95661-3097
(916) 773-6200
(916) 782-4550
Mailing address
1860 SIERRA GARDENS DR UNIT 850, ROSEVILLE, CA 95661-1034
(916) 773-6200
(916) 782-4550

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A71917
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A71917
CA MEDICAL LICENSE
CA
01
ZZZ13841Z
MEDICARE ID - ROSEVILLE
CA
01
ZZZ13842Z
MEDICARE ID - CARMICHAEL
CA
01
ZZZ29516Z
MEDICARE ID - LINCOLN
CA
01
ZZZ43589Z
MEDICARE SUBMITTER ID
CA
Enumeration date
02/07/2007
Last updated
03/30/2026
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