Provider Demographics
NPI:1730101981
Name:GOOD, RANDY ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:ALAN
Last Name:GOOD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23502 LYONS AVENUE STE 102A
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91321
Mailing Address - Country:US
Mailing Address - Phone:661-254-8890
Mailing Address - Fax:661-254-8891
Practice Address - Street 1:23502 LYONS AVENUE STE 102A
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321
Practice Address - Country:US
Practice Address - Phone:661-254-8890
Practice Address - Fax:661-254-8891
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC18420111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00160683OtherRAILROAD MEDICARE
CAP00160683OtherRAILROAD MEDICARE
CAU29822Medicare UPIN