Individual
DR. RANDALL K WENOKUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6600 LONE TREE WAY, BRENTWOOD, CA 94513-5256
(925) 685-7400
(925) 685-0917
Mailing address
6600 LONE TREE WAY, BRENTWOOD, CA 94513-5256
(925) 685-7400
(925) 685-0917
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
F80706
CA
207YX0602X
Otolaryngic Allergy Physician
F80706
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G67072
LICENSE
CA
01
—
ZZZ21406Z
MEDICARE GROUP #
—
Enumeration date
10/13/2006
Last updated
02/10/2025
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