Provider Demographics
NPI:1255368726
Name:LOW, RANDALL (MD)
Entity type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:
Last Name:LOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 PACIFIC AVE
Mailing Address - Street 2:SUITE 501
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94133
Mailing Address - Country:US
Mailing Address - Phone:415-956-8339
Mailing Address - Fax:415-956-8391
Practice Address - Street 1:728 PACIFIC AVE
Practice Address - Street 2:SUITE 501
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-4457
Practice Address - Country:US
Practice Address - Phone:415-956-8339
Practice Address - Fax:415-956-8391
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG32525207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G325250Medicaid
CAA45183Medicare UPIN
CAG32525Medicare ID - Type Unspecified