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General NPI Number Information
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NPI Number | 1104244243
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Entity Type | Individual
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Provider Name | DR. MARTINA RANDALL
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Gender | Female
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Dates
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Enumeration Date | 04/05/2014
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 500 E OLIVE AVE STE 840
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City | BURBANK
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State | CA
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Zip | 91501-2180
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Country | US
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Telephone | 213-373-3246
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Fax | 800-878-5903
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Provider Business Mailing Address
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Address Line | 6444 SAN FERNANDO RD UNIT 5611
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City | GLENDALE
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State | CA
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Zip | 91201-5079
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Country | US
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Telephone | 213-373-3246
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Fax | 800-878-5903
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E5465
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License Number State | CA
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