Active NPI
Randall a. Ichihana
- Physiological Laboratory
- San Rafael, CA
National Provider Identifier
1568455152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physiological Laboratory
- Legal business name
- RANDALL A. ICHIHANA
- Doing business as
- MARIN PULMONARY SERVICE
- Practice address
- 1050 Northgate Dr
Suite 250 a
San Rafael, CA 94903-2526 - Phone
- (415) 925-1626
- Fax
- (415) 925-1826
- NPI assigned
- Aug 29, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Randall Akira Ichihana, R.C.P. , RPFT
- Title
- Owner
- Phone
- (415) 925-1626
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physiological Laboratory | 293D00000X | CA | Primary |
Addresses
Primary practice location
1050 Northgate Dr
Suite 250 a
San Rafael, CA 94903-2526
Mailing address
PO Box 11201
San Rafael, CA 94912-1201
Phone (415) 925-1626
Other names 1
- MARIN PULMONARY SERVICE
National Provider Directory
National Provider DirectoryLocations
1050 Northgate Dr
Ste 250A
San Rafael, CA 94903
Phone (415) 925-1626
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125273600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1349308800000",
"number": "1568455152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11201",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949121201",
"telephone_number": "415-925-1626",
"fax_number": "415-925-1826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 NORTHGATE DR",
"address_2": "SUITE 250 A",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949032526",
"telephone_number": "415-925-1626",
"fax_number": "415-925-1826"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RANDALL A. ICHIHANA",
"organizational_subpart": "NO",
"enumeration_date": "2005-08-29",
"last_updated": "2012-10-04",
"status": "A",
"authorized_official_last_name": "ICHIHANA",
"authorized_official_first_name": "RANDALL",
"authorized_official_middle_name": "AKIRA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "415-925-1626",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "R.C.P. , RPFT"
},
"taxonomies": [
{
"code": "293D00000X",
"taxonomy_group": "",
"desc": "Physiological Laboratory",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "MARIN PULMONARY SERVICE",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.