Provider Demographics
NPI:1275568412
Name:WEIL, RANDALL BRADLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:BRADLEY
Last Name:WEIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:909 HYDE ST
Mailing Address - Street 2:SUITE 602
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4822
Mailing Address - Country:US
Mailing Address - Phone:415-781-2081
Mailing Address - Fax:415-567-1402
Practice Address - Street 1:909 HYDE ST
Practice Address - Street 2:SUITE 602
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4822
Practice Address - Country:US
Practice Address - Phone:415-781-2081
Practice Address - Fax:415-567-1402
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC36883208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery