Provider Demographics
NPI:1023381449
Name:JOSEPH, RANDY
Entity type:Individual
Prefix:
First Name:RANDY
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1814 FRANKLIN ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3487
Mailing Address - Country:US
Mailing Address - Phone:510-318-6100
Mailing Address - Fax:510-830-3318
Practice Address - Street 1:1814 FRANKLIN ST
Practice Address - Street 2:SUITE 400
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-3487
Practice Address - Country:US
Practice Address - Phone:510-318-6100
Practice Address - Fax:510-830-3318
Is Sole Proprietor?:No
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist