Individual provider Active NPI

Gayle Madeleine Randall, MD

  • Internal Medicine Physician
  • Woodland Hills, CA
National Provider Identifier
1417043365
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G51884 Issued in CA
Practice address
23123 Ventura Blvd
Suite 104a
Woodland Hills, CA 91364-1162
Phone
(818) 591-7600
Fax
(818) 591-7600
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G51884 CA Primary

Addresses

Primary practice location

23123 Ventura Blvd
Suite 104a
Woodland Hills, CA 91364-1162

Mailing address

23123 Ventura Blvd
Suite 104a
Woodland Hills, CA 91364-1104
Phone (818) 591-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Dec 30, 2016 through Dec 30, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G51884CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Litos O. Mallare, M.D., Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302048000000",
    "number": "1417043365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23123 VENTURA BLVD",
            "address_2": "SUITE 104A",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641104",
            "telephone_number": "818-591-7600",
            "fax_number": "818-591-7605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23123 VENTURA BLVD",
            "address_2": "SUITE 104A",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641162",
            "telephone_number": "818-591-7600",
            "fax_number": "818-591-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "GAYLE",
        "middle_name": "MADELEINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2011-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G51884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

Verify at the official NPI Registry.