Ice, Randolph George

Ice, Randolph George is an individual health care provider with primary practice located at 25150 Hancock Ave Ste 100, Murrieta CA 92562-5987. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Cardiopulmonary. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is his primary health care specialty. Ice, Randolph George can be contacted via phone (951) 698-7720.

Contact Information

Primary practice address
25150 Hancock Ave Ste 100 Murrieta CA 92562-5987
Phone: (951) 698-7720
Fax: (951) 698-7451
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT6020 California
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Cardiopulmonary 2251C2600X PT 6020 California

Profile Details

NPI number 1851375083
LBN Legal business name Ice, Randolph George
Credentials Registered Physical Therapist (RPT)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2005
Last updated Oct 7th, 2009 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851375083 NPPES
California Other 00PT60200 BLUE SHIELD OF CALIFORNIA

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