Organization Active NPI

Randall a. Ichihana

  • Physiological Laboratory
  • San Rafael, CA
National Provider Identifier
1568455152
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
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

Updated by the provider on Oct 4, 2012

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)CodeLicenseStatePrimary
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 Doing business as

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.