Shyam Randeria
Family Doctor Geriatric Medicine
13652 Cantara St / Balboa Plaza
Panorama City
, California 91402
Shyam Randeria
Family Doctor Geriatric Medicine
13652 Cantara St / Balboa Plaza
Panorama City
, California 91402
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About
Features
Specialties
- Family Doctor
- Geriatric Medicine
Languages spoken
- English
Location
First Address
- Shyam Randeria
- 10605 Balboa Blvd Ste 330
- Granada Hills, CA
- Zip : 91344-6358
- Phone :
Second Address
- Shyam Randeria
- 13652 Cantara St / Balboa Plaza
- Panorama City, CA
- Zip : 91402
- Phone : (818) 832-7292
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Q00000X | Family Doctor | A101775 | CA |
| N | 207RG0300X | Geriatric Medicine | 27588 | AL |
National Provider Identifier
| NPI | 1043424419 |
|---|---|
| Provider Name | Shyam Randeria |
| First Address | Granada Hills, CA 91344-6358 |
| Second Address | Panorama City, CA 91402 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/05/2007 |
| Last Update Date | 08/12/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.