H. Randall Hicks, M.D. Inc, H Randall Hicks Pres

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G47439 Issued in CA

Legal business name

H. RANDALL HICKS, M.D. INC, H RANDALL HICKS PRES

Practice address

4060 Fourth Ave
Suite 615
San Diego, CA 92103-2116

Phone

(619) 298-7135

Fax

(858) 874-8837

NPI assigned

Nov 8, 2010

Organization subpart

No

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

Authorized official

Name

H. Randall Hicks, M.D.

Title

President & Ceo

Phone

(619) 298-7135

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Howard Randall Hicks, MD

  • Psychiatry Physician
  • San Diego, CA
  • NPI 1073628228
  Medicare reassignment
• Kurt Helfrich

  • Marriage & Family Therapist
  • San Diego, CA
  • NPI 1376831149
  NPD (past)

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393891200000",
    "number": "1497056386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 FOURTH AVE",
            "address_2": "SUITE 615",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032116",
            "telephone_number": "619-298-7135",
            "fax_number": "858-874-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 FOURTH AVE",
            "address_2": "SUITE 615",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032116",
            "telephone_number": "619-298-7135",
            "fax_number": "858-874-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H. RANDALL HICKS, M.D. INC, H RANDALL HICKS PRES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-08",
        "last_updated": "2014-03-04",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "H. RANDALL",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "619-298-7135",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G47439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.