Individual
RANDEL EDWARD JOHANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.D.O.
Contact information
Practice address
1722 MANGROVE AVE, SUITE 32, CHICO, CA 95926-2300
(530) 895-1474
(530) 895-1441
Mailing address
1722 MANGROVE AVE, SUITE 32, CHICO, CA 95926-2300
(530) 895-1474
(530) 895-1441
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
D3437
CA
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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