Individual
DR. JEFFREY BLAINE RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20055 LAKE CHABOT RD, # 110, CASTRO VALLEY, CA 94546
(510) 886-3138
(510) 373-1616
Mailing address
20055 LAKE CHABOT RD, # 110, CASTRO VALLEY, CA 94546
(510) 886-3138
(510) 373-1616
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
G68717
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G687170
—
CA
Enumeration date
05/03/2006
Last updated
12/28/2009
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