JACKSON RANDOLPH

SAN LUIS OBISPO, CA
NPI1063040970
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207Y00000X Otolaryngology
(Licence: CA  A202960)
Enumeration Date2020-03-28
Last Update Date2025-06-14
Business Address
JACKSON RANDOLPH MD
35 CASA ST STE 130
SAN LUIS OBISPO, CA 93405-1887
Phone number: 805-541-1422
Mailing Address
JACKSON RANDOLPH MD
35 CASA ST STE 130
SAN LUIS OBISPO, CA 93405-1887
Phone number: 805-541-1422