Healthcare Provider Details

I. General information

NPI: 1437426285
Provider Name (Legal Business Name): RANDY TALAI M.S., D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2011
Last Update Date: 04/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 WILSHIRE BLVD #400
LOS ANGELES CA
90010-1577
US

IV. Provider business mailing address

3250 WILSHIRE BLVD #400
LOS ANGELES CA
90010-1577
US

V. Phone/Fax

Practice location:
  • Phone: 818-610-9339
  • Fax:
Mailing address:
  • Phone: 818-610-9339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberDC26660
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: