SAM RANDOLPH (NPI# 1609484286) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609484286 |
| Entity Type | Individual |
| Full Name | SAM RANDOLPH |
| Practice Address |
2677 Zoe Ave Ste 304 Huntington Park CA 90255-3699 |
| Practice Telephone | 3233460960 |
| Practice Fax Number | 3233460966 |
| Mailing Telephone | 3233460960 |
| Mailing Fax Number | 3233460966 |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2020-07-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225400000X | Rehabilitation Practitioner | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
2677 ZOE AVE STE 304 |
| City | HUNTINGTON PARK |
| State | CA |
| Zip Code | 90255-3699 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831218270 | Ruben Uribe | Rehabilitation Practitioner | 2677 Zoe Ave Ste 304, Huntington Park, CA 90255-3699 | 2007-03-28 |
| 1487255725 | Maria R. Campos | Rehabilitation Practitioner | 2677 Zoe Ave Ste 304, Huntington Park, CA 90255-3699 | 2020-11-03 |
| 1275132060 | Michael Geron | Rehabilitation Practitioner | 2677 Zoe Ave Ste 304, Huntington Park, CA 90255-3699 | 2020-10-22 |
| 1518565381 | Moses Torres Ramirez | Rehabilitation Practitioner | 2677 Zoe Ave Ste 304, Huntington Park, CA 90255-3699 | 2020-10-14 |
| 1194323865 | Lehman Locklin | Rehabilitation Practitioner | 2677 Zoe Ave Ste 304, Huntington Park, CA 90255-3699 | 2020-10-14 |
| 1790383834 | Nia Lancelin-brantly | Rehabilitation Practitioner | 2677 Zoe Ave Ste 304, Huntington Park, CA 90255-3699 | 2020-10-12 |
| 1689272718 | Jessica Brittney Diaz | Rehabilitation Practitioner | 2677 Zoe Ave Ste 304, Huntington Park, CA 90255-3699 | 2020-10-12 |
| 1114525268 | Joanna Marieh Gonzalez | Rehabilitation Practitioner | 2677 Zoe Ave Ste 304, Huntington Park, CA 90255-3699 | 2020-10-12 |
| 1992303028 | Johana Lozano | Rehabilitation Practitioner | 2677 Zoe Ave Ste 304, Huntington Park, CA 90255-3699 | 2020-10-12 |
| 1912505058 | Rosalyn Star Wiley | Rehabilitation Practitioner | 2677 Zoe Ave Ste 304, Huntington Park, CA 90255-3699 | 2020-10-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922659424 | Maria Hurtado | Behavior Technician | California St & Pacific Blvd, Walnut Park, CA 90255 | 2019-09-25 |
| 1356803555 | Cdf Centro De Desarrollo Familiar | Social Worker | 2677 Zoe Ave Suite 120, Huntington Park, CA 90255 | 2019-04-05 |
| 1710457908 | Toure Marshawn Curry | Rehabilitation Practitioner | 2677 Zoe Ave #304, Huntington Park, CA 90255 | 2018-11-29 |
| 1508366584 | Kalie Marie Baker | Optometrist | 2614 Gage Ave, Huntington Park, CA 90255 | 2018-02-16 |
| 1134633027 | Alicia Rizkalla | Case Manager/Care Coordinator | Altamed Pace, 1900 Slauson Street, Huntington Park, CA 90255 | 2017-11-30 |
| 1205353760 | All Care One Community Health Center | Chiropractor | 7300 Santa Fe Avenue, Huntington Park, CA 90255 | 2017-08-25 |
| 1447613559 | Peter Vue | Respiratory Therapist, Certified | 6208 Seville Ave., Huntington Park, CA 90255 | 2016-04-05 |
| 1558720029 | Dr. Edmond Janfaza Dds, Inc. | Dentist | 2675 E. Slauson Ave, #300, Huntington Park, CA 90255 | 2016-02-12 |
| 1649650979 | Samuel Zaki Dds Inc | Dentist | 7221 Pacific Blvd, Huntington Park, CA 90255 | 2015-06-02 |
| 1376945808 | Karla Zuniga | Case Manager/Care Coordinator | 3638 E 61st Street, Huntington Park, CA 90255 | 2014-09-16 |
| Find all providers in zip 90255 | ||||
| Taxonomy Code | 225400000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Rehabilitation Practitioner |
| A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710457908 | Toure Marshawn Curry | Rehabilitation Practitioner | 2677 Zoe Ave #304, Huntington Park, CA 90255 | 2018-11-29 |
| 1447763248 | Krisette Drumgole | Rehabilitation Practitioner | 6533 Seville Ave, Huntington Park, CA 90255-4208 | 2017-11-15 |
| 1003155615 | Martha Ayala | Rehabilitation Practitioner | 2677 Zoe Ave. Suite #304, Huntington Park, CA 90255 | 2013-02-04 |
| 1326313669 | Jason Edward Garcia | Rehabilitation Practitioner | 2677 Zoe Ave Ste 112, Huntington Park, CA 90255-6995 | 2012-03-20 |
| 1811284292 | Constantino Donaciano Antonio | Rehabilitation Practitioner | 2677 1/2 Zoe Ave., Huntington Park, CA 90255 | 2011-07-06 |
| 1053430116 | Feliza Perez | Rehabilitation Practitioner | 2677 1/2 202 Ave, Huntington Park, CA 90065 | 2007-03-28 |
| 1831218270 | Ruben Uribe | Rehabilitation Practitioner | 2677 Zoe Ave Ste 304, Huntington Park, CA 90255-3699 | 2007-03-28 |
| 1548386626 | Project Return Peer Support Network | Rehabilitation Practitioner | 2677 Zoe Ave Suite #304, Huntington Park, CA 90255-4195 | 2007-03-21 |
| 1487255725 | Maria R. Campos | Rehabilitation Practitioner | 2677 Zoe Ave Ste 304, Huntington Park, CA 90255-3699 | 2020-11-03 |
| 1275132060 | Michael Geron | Rehabilitation Practitioner | 2677 Zoe Ave Ste 304, Huntington Park, CA 90255-3699 | 2020-10-22 |
| Find all providers in HUNTINGTON PARK | ||||
| City | HUNTINGTON PARK |
| Zip Code | 90255 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.