Organization Active NPI

Randall Healthcare Inc

  • Internal Medicine Physician
  • Oakland, CA
National Provider Identifier
1023385101
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G62879 Issued in CA
Legal business name
RANDALL HEALTHCARE INC
Practice address
350 30TH St
#100
Oakland, CA 94609-3424
Phone
(510) 342-2239
Fax
(510) 380-7143
NPI assigned
Nov 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Randall Leroy Tan, MD
Title
MD
Phone
(510) 342-2239

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X G62879 CA Primary

Addresses

Primary practice location

350 30TH St
#100
Oakland, CA 94609-3424

Mailing address

360 Grand Ave
#332
Oakland, CA 94610-4840
Phone (510) 342-2239

National Provider Directory

National Provider Directory

Locations

360 Grand Ave
Oakland, CA 94610
Phone (510) 394-5065

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321488000000",
    "number": "1023385101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 GRAND AVE",
            "address_2": "#332",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946104840",
            "telephone_number": "510-342-2239",
            "fax_number": "510-380-7143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 30TH ST",
            "address_2": "#100",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093424",
            "telephone_number": "510-342-2239",
            "fax_number": "510-380-7143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALL HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-17",
        "last_updated": "2011-11-17",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "LEROY",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "510-342-2239",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G62879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.