MEDICARE: DR. RANDALL JAMES LANKFORD DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	20A9681	CA

General Provider Information

NPI Number	:	1013061647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RANDALL JAMES LANKFORD DO

Provider Business Mailing Address
First Line	:	5814 OLD BARN WAY
Second Line	:
City	:	REDDING
State	:	CA
Zip	:	96001-4654
Country	:	US
Telephone Number	:	530-246-3620
Fax Number	:

Provider Business Practice Location Address
First Line	:	5814 OLD BARN WAY
Second Line	:
City	:	REDDING
State	:	CA
Zip	:	96001-4654
Country	:	US
Telephone Number	:	530-246-3620
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	07/08/2007

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