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General NPI Number Information
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NPI Number | 1316566003
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Entity Type | Individual
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Provider Name | ATTIYA HARIT RANDOLPH MD
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Gender | Female
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Dates
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Enumeration Date | 04/13/2020
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 850 FAIR OAKS AVE STE 220
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-3929
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Country | US
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Telephone | 805-547-2224
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Fax | 805-474-5248
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Provider Business Mailing Address
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Address Line | 850 FAIR OAKS AVE STE 220
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-3929
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Country | US
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Telephone | 805-547-2224
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Fax | 805-474-5248
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | A204791
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License Number State | CA
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