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General NPI Number Information
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NPI Number | 1538521125
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Entity Type | Organization
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Legal Business Name | RANDAL SLOOP MD INC
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Dates
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Enumeration Date | 03/23/2016
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Last Update Date | 03/23/2016
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Provider Practice Location Address
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Address Line | 2068 TALBERT DR STE 150
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City | CHICO
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State | CA
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Zip | 95928-7723
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Country | US
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Telephone | 530-809-0009
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Fax | 530-809-0399
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Provider Business Mailing Address
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Address Line | 2068 TALBERT DR STE 150
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City | CHICO
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State | CA
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Zip | 95928-7723
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Country | US
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Telephone | 530-809-0009
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Fax | 530-809-0399
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Authorized Official
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Title or Position | PRESIDENT
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Name | RANDAL SLOOP
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Credential | MD
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Telephone | 530-809-0009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | G63549
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G61004
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License Number State | CA
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