SAMUEL RANDOLPH, MD, Diagnostic Radiology LOMA LINDA, CA

Contact Information

SAMUEL RANDOLPH, MD

11234 ANDERSON ST
LLUMC HOUSE STAFF OFFICE CP 21005
LOMA LINDA, CA 92354

Phone: 909-558-1000
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Diagnostic Radiology	2085R0202X	30	Physician/Diagnostic Radiology

Indicates primary specialty

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NPI Profile & details for SAMUEL RANDOLPH · (Male)

NPI Number	`1508068958`
Status	Active
Credentials	MD
Entity	Individual
Enumeration date	06/05/2007
Last updated	07/08/2007 - About 19 years ago
Sole proprietor ¹	No
Identifiers	CA License # A97396
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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