Active NPI
Randall Lee Gibson
- Addiction (Substance Use Disorder) Counselor
- Hollywood, CA
National Provider Identifier
1922450600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 6838 W Sunset Blvd
Hollywood, CA 90028-7008 - Phone
- (323) 461-3161
- Fax
- (323) 461-5683
- NPI assigned
- Jul 6, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
6838 W Sunset Blvd
Hollywood, CA 90028-7008
Mailing address
6838 W Sunset Blvd
Hollywood, CA 90028-7008
Phone (323) 461-3161
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Los Angeles County Department of Public Health | Current | Accepting new patients |
Interoperability endpoints
- randallgibson-bhs-inc@lacsapc.netsmartdirect.net
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Public Health or Welfare Agency
- Alhambra, CA
- NPI 1700090834
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467763200000",
"number": "1922450600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6838 W SUNSET BLVD",
"city": "HOLLYWOOD",
"state": "CA",
"postal_code": "900287008",
"telephone_number": "323-461-3161",
"fax_number": "323-461-5683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6838 W SUNSET BLVD",
"city": "HOLLYWOOD",
"state": "CA",
"postal_code": "900287008",
"telephone_number": "323-461-3161",
"fax_number": "323-461-5683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "RANDALL",
"middle_name": "LEE",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-06",
"last_updated": "2016-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.