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General NPI Number Information
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NPI Number | 1154937001
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Entity Type | Individual
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Provider Name | CHRISTOPHER RANDALL PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/16/2020
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 5818 N NEVADA AVE STE 110
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-3505
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Country | US
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Telephone | 719-365-1950
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Fax | 719-364-0022
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Provider Business Mailing Address
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Address Line | 2695 ROCKY MOUNTAIN AVE STE 150
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City | LOVELAND
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State | CO
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Zip | 80538-9071
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Country | US
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Telephone | 719-365-1950
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Fax | 719-364-0022
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 2477
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PT1013
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License Number State | WY
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.0009381
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 105753
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License Number State | IA
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