Individual
DR. RANDOLPH BRYANT COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
850 FAIR OAKS AVE STE 100, ARROYO GRANDE, CA 93420-3929
(805) 473-0700
(805) 473-5931
Mailing address
850 FAIR OAKS AVE STE 100, ARROYO GRANDE, CA 93420-3929
(805) 473-0700
(805) 473-5931
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G89412
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB218593
MEDICARE ID
CA
Enumeration date
02/14/2006
Last updated
11/02/2023
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