Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | DC19943 | CA |
NPI | 1962627141 |
---|---|
Provider Name | Dr. Randall Scott Perry |
First Address | Sacramento, CA 95825-2000 |
Second Address | Sacramento, CA 95825-2000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2007 |
Last Update Date | 08/07/2007 |