Healthcare Provider Details

I. General information

NPI: 1720204670
Provider Name (Legal Business Name): RANDALL GAY MARCH D.C., D.A.C.N.B.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 09/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 AVONDALE AVE SUITE 1
SACRAMENTO CA
95825-1387
US

IV. Provider business mailing address

1840 AVONDALE AVE. SUITE 1
SACRAMENTO CA
95825-1387
US

V. Phone/Fax

Practice location:
  • Phone: 916-482-4150
  • Fax: 916-482-4493
Mailing address:
  • Phone: 916-482-4150
  • Fax: 916-482-4493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC 23901
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberDC 23901
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberDC 23901
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: