Individual
RANDALL GORDON STERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1247 E ALLUVIAL AVE STE 101, FRESNO, CA 93720-2686
(559) 431-6226
(559) 440-9005
Mailing address
2625 E DIVISADERO ST, FRESNO, CA 93721-1431
(559) 443-2682
(559) 443-2681
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
G33214
CA
2086S0129X
Vascular Surgery Physician
Primary
G33214
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G332140
—
CA
01
—
P00170705
RAILROAD MEDICARE
CA
Enumeration date
08/30/2006
Last updated
11/07/2019
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