Provider Demographics
NPI:1760426472
Name:WINSLOW, RANDALL SCOTT (DO)
Entity Type:Individual
Prefix:MR
First Name:RANDALL
Middle Name:SCOTT
Last Name:WINSLOW
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:10271 WILDHAWK DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95829-6572
Mailing Address - Country:US
Mailing Address - Phone:916-212-8067
Mailing Address - Fax:
Practice Address - Street 1:1 SCRIPPS DR STE 202
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6206
Practice Address - Country:US
Practice Address - Phone:916-927-1114
Practice Address - Fax:916-927-3244
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2021-12-14
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Provider Licenses
StateLicense IDTaxonomies
CA20A8110207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI05872Medicare UPIN