Kalyani Randeria, M.D. Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A45174 Issued in CA

Legal business name

KALYANI RANDERIA, M.D. INC

Practice address

101 E Beverly Blvd Ste 405
Montebello, CA 90640-4317

Phone

(323) 724-9767

Fax

(323) 724-2722

NPI assigned

Dec 16, 2010

Organization subpart

No

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

Authorized official

Name

Kalyani Randeria, M.D.

Title

Medical Director

Phone

(323) 724-9767

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1292457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302652800000",
    "number": "1205139094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E BEVERLY BLVD STE 405",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404317",
            "telephone_number": "323-724-9767",
            "fax_number": "323-724-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E BEVERLY BLVD STE 405",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404317",
            "telephone_number": "323-724-9767",
            "fax_number": "323-724-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALYANI RANDERIA, M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-16",
        "last_updated": "2011-04-13",
        "status": "A",
        "authorized_official_last_name": "RANDERIA",
        "authorized_official_first_name": "KALYANI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "323-724-9767",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A45174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Montebello, CA
• Providers in Montebello, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.