Basic Information
| Provider Information | |||||||||
| NPI: | 1538521125 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RANDAL SLOOP MD INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2068 TALBERT DR STE 150 | ||||||||
| Address2: | |||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959287723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308090009 | ||||||||
| FaxNumber: | 5308090399 | ||||||||
| Practice Location | |||||||||
| Address1: | 2068 TALBERT DR STE 150 | ||||||||
| Address2: | |||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959287723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308090009 | ||||||||
| FaxNumber: | 5308090399 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2016 | ||||||||
| LastUpdateDate: | 03/23/2016 | ||||||||
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| AuthorizedOfficialLastName: | SLOOP | ||||||||
| AuthorizedOfficialFirstName: | RANDAL | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5308090009 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | G63549 | CA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | 207Q00000X | G61004 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.