Organization Active NPI

Gurinder K Randhawa MD Inc

  • General Practice Physician
  • Lafayette, CA
National Provider Identifier
1861870230
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G67417 Issued in CA
Legal business name
GURINDER K RANDHAWA MD INC
Practice address
970 Dewing Ave
Suite 300
Lafayette, CA 94549-4291
Phone
(925) 283-3122
Fax
(925) 283-3140
NPI assigned
May 18, 2015
Last updated
Feb 21, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Authorized official

Name
Gurinder K Randhawa, M.D.NPI 1043235195
Title
President
Phone
(925) 283-3122

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X G67417 CA Primary

Addresses

Primary practice location

970 Dewing Ave
Suite 300
Lafayette, CA 94549-4291

Mailing address

3514 Eagle Point Rd
Lafayette, CA 94549-2330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150709001968 CA Part B Supplier - Clinic/Group Practice 2466764071 Receives reassigned benefits from 1 practitioner
Practice locations: Lafayette, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2123527Gurinder K. Randhawa, MD970 Dewing Ave Ste 300, Lafayette, CA 94549Certificate of waiverDec 21, 2026

National Provider Directory

National Provider Directory

Locations

970 Dewing Ave
Ste 300
Lafayette, CA 94549
Phone (925) 283-3122

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1431907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487635200000",
    "number": "1861870230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3514 EAGLE POINT RD",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945492330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 DEWING AVE",
            "address_2": "SUITE 300",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945494291",
            "telephone_number": "925-283-3122",
            "fax_number": "925-283-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GURINDER K RANDHAWA MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-18",
        "last_updated": "2017-02-21",
        "status": "A",
        "authorized_official_last_name": "RANDHAWA",
        "authorized_official_first_name": "GURINDER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-283-3122",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G67417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.