Provider Demographics
NPI:1013032655
Name:RAMSEY, RANDALL S (OD)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:S
Last Name:RAMSEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4550 TASSAJARA RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-4610
Mailing Address - Country:US
Mailing Address - Phone:925-479-0400
Mailing Address - Fax:925-479-0401
Practice Address - Street 1:4550 TASSAJARA RD
Practice Address - Street 2:SUITE C
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-4610
Practice Address - Country:US
Practice Address - Phone:925-479-0400
Practice Address - Fax:925-479-0401
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6101T152WC0802X
KS1072-1152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD006647Medicaid
CASD006647Medicaid
CA430283Medicare UPIN