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NPI Code Detail

MEDICARE: RANDAL C CHRISTENSEN M.D.

MEDICARE: RANDAL C CHRISTENSEN M.D.
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
1208000000XPediatrics Physician25554AZ
2208000000XPediatrics Physician16744NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
116744OTHERNVNEVADA MEDICAL LICENSE

General Provider Information

NPI Number : 1700849015
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDAL C CHRISTENSEN M.D.
Provider Business Mailing Address
First Line : 3325 RESEARCH WAY
Second Line :
City : CARSON CITY
State : NV
Zip : 89706-7913
Country : US
Telephone Number : 775-888-6610
Fax Number : 775-888-4904
Provider Business Practice Location Address
First Line : 1799 MOUNT MARIAH DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-1501
Country : US
Telephone Number : 702-383-1961
Fax Number : 702-319-6147
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2006
Last Update Date : 10/12/2016

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Directions to “ RANDAL C CHRISTENSEN M.D.” Practice Location

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