Individual
RANDY R GRAY
Active
Individual
RANDY R GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
258
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700954070
—
CA
01
—
NA258
CERTIFIED NURSE ANETHETIS
CA
Enumeration date
12/02/2006
Last updated
01/31/2014
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