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General NPI Number Information
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NPI Number | 1679603344
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Entity Type | Organization
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Legal Business Name | H RANDOLPH BROWN O D INC
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/18/2023
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Provider Practice Location Address
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Address Line | 11226 GOLD EXPRESS DRIVE STE 202
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City | GOLD RIVER
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State | CA
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Zip | 95670
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Country | US
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Telephone | 916-635-1037
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Fax |
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Provider Business Mailing Address
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Address Line | 11226 GOLD EXPRESS DRIVE STE 202
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City | GOLD RIVER
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State | CA
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Zip | 95670
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Country | US
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Telephone | 916-635-1037
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. H RANDOLPH BROWN
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Credential |
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Telephone | 916-635-1037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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