Provider Demographics
NPI:1861634461
Name:RANDALL W WARING, M.D.,INC.
Entity Type:Organization
Organization Name:RANDALL W WARING, M.D.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:WINSTON
Authorized Official - Last Name:WARING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-243-0440
Mailing Address - Street 1:373 PARK MARINA CIR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-0965
Mailing Address - Country:US
Mailing Address - Phone:530-243-0440
Mailing Address - Fax:530-243-0445
Practice Address - Street 1:121 RALEY BLVD
Practice Address - Street 2:SKYWAY SURGERY CENTER
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-8347
Practice Address - Country:US
Practice Address - Phone:530-898-8142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-27
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG46772174400000X, 207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA50492Medicare UPIN