Individual
DR. RANDY J MOUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1746 COLE BLVD, SUITE 150, LAKEWOOD, CO 80401-3208
(303) 914-8800
Mailing address
1746 COLE BLVD, STE 150, LAKEWOOD, CO 80401-3208
(303) 914-8800
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
33784
CO
2085R0202X
Diagnostic Radiology Physician
G31418
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G3141480
BLUE SHIELD
CA
05
—
00G314180
—
CA
01
—
029426
KAISER COMMERCIAL NUMBER
CO
05
—
74707817
—
CO
Enumeration date
05/26/2006
Last updated
03/10/2023
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