Gilman, Randal Keith
Gilman, Randal Keith is an individual health care provider with primary practice located at 11234 Anderson St , Loma Linda CA 92354-2804. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Gilman, Randal Keith can be contacted via phone (909) 558-4475.Contact Information
Primary practice address
11234 Anderson St
Loma Linda CA 92354-2804
Phone: (909) 558-4475
Fax: (909) 558-4143
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA14703 | California |
Profile Details
| NPI number | 1003863432 |
|---|---|
| LBN Legal business name | Gilman, Randal Keith |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 30th, 2006 |
| Last updated | Jun 4th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003863432 | NPPES |
| California | MEDICAID | PA14703 | |
| California | MEDICAID | GR0058270 | |
| California | MEDICAID | GR0058271 |
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