Randolph Dale Blattler, R.N., RNFA

Primary specialty

Registered Nurse First AssistantTaxonomy code 163WR0006X

License

547610 Issued in CA

Practice address

8624 Carlton Oaks Dr
Santee, CA 92071-2214

Phone

(619) 851-7625

NPI assigned

Feb 7, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1423267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423267200000",
    "number": "1316338718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4647 ZION AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921202507",
            "telephone_number": "619-528-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8624 CARLTON OAKS DR",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920712214",
            "telephone_number": "619-851-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLATTLER",
        "first_name": "RANDOLPH",
        "middle_name": "DALE",
        "credential": "R.N., RNFA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-07",
        "last_updated": "2015-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "CA",
            "license": "547610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse First Assistant in Santee, CA
• Providers in Santee, CA by specialty
• Registered Nurse First Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2015; 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.