Roark, Randall Alan

Roark, Randall Alan is an individual health care provider with primary practice located at 949 Palm Ave , Imperial Beach CA 91932. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Roark, Randall Alan can be contacted via phone (619) 429-3733.

Contact Information

Primary practice address
949 Palm Ave Imperial Beach CA 91932
Phone: (619) 429-3733
Fax: (619) 628-5550
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 568148 California
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 15996 California

Profile Details

NPI number 1447312178
LBN Legal business name Roark, Randall Alan
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 16th, 2006
Last updated Nov 12th, 2018 - about 8 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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