Individual
GUY P. RANDAZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13522 NEWPORT AVE STE 102, TUSTIN, CA 92780-3707
(714) 573-8200
(714) 573-9401
Mailing address
PO BOX 15090, ANAHEIM, CA 92803-5090
(714) 577-2124
(714) 577-2125
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
A22452
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912919804
—
CA
05
—
CB292883
—
CA
Enumeration date
03/14/2006
Last updated
03/30/2020
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