NPIMap

Individual provider Active NPI

Randall Joseph Punu Poblete, MSPAS, MPH, PA-C

  • Physician Assistant
  • Walnut Creek, CA
National Provider Identifier
1700225174
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA23021 Issued in CA
Practice address
1914 Tice Valley Blvd
Walnut Creek, CA 94595-2203
Phone
(925) 988-7533
NPI assigned
Jun 19, 2013
Last updated
May 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA23021 CA Primary

Addresses

Primary practice location

1914 Tice Valley Blvd
Walnut Creek, CA 94595-2203

Mailing address

1450 Treat Blvd Ste 300
Walnut Creek, CA 94597-2168
Phone (925) 952-2828

Other practice location 1

275 Beck Ave
Fairfield, CA 94533-6804
Phone (707) 784-2028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201111003046 CA Practitioner - Physician Assistant 3072741594 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
John Muir Physician NetworkGroup PAC ID 6608789813, 488 clinicians

Practice addresses (Care Compare)

1914 Tice Valley Blvd
Walnut Creek, CA 94595-2203
Phone (925) 988-7595

2400 Balfour Rd
Suite 120
Brentwood, CA 94513-4956
Phone (925) 308-8112

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA23021CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Nov 3, 2020 Accepting new patients
UCSF Medical Group Business Services CurrentSince Nov 3, 2020 Accepting new patients
UCSF Medical Group Business Services CurrentSince Nov 3, 2020 Accepting new patients
University of California San Francisco CurrentSince Nov 3, 2020 Accepting new patients
John Muir Physician Network CurrentSince Jun 2, 2025 Accepting new patients

Locations

2400 Balfour Rd
Ste 120
Brentwood, CA 94513
Phone (925) 308-8112

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

1450 Treat Blvd
Ste 300
Walnut Creek, CA 94597

1914 Tice Valley Blvd
Walnut Creek, CA 94595
Phone (925) 372-8780

Interoperability endpoints

  • Direct secure messaging: rpoblete185014@ehr.johnmuirhealth.com
  • Direct secure messaging: rpoblete716996@direct.ochin.org

Organizations & group practices 9

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1700225174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 TREAT BLVD STE 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945972168",
            "telephone_number": "925-952-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1914 TICE VALLEY BLVD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945952203",
            "telephone_number": "925-988-7533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 Beck Ave",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "945336804",
            "country_code": "US",
            "telephone_number": "707-784-2028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POBLETE",
        "first_name": "RANDALL JOSEPH",
        "middle_name": "PUNU",
        "name_prefix": "Mr.",
        "credential": "MSPAS, MPH, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-19",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA23021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.