| Randy Hawkins, M.d., Inc | |
|
644 E Regent St #200 Inglewood CA 90301-1433 | |
| (310) 674-1970 | |
| (310) 674-7712 |
| Full Name | Randy Hawkins, M.d., Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 644 E Regent St, Inglewood, California |
| Authorized Official Name and Position | Randy Hawkins (PRESIDENT) |
| Authorized Official Contact | 3106741970 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Randy Hawkins, M.d., Inc 6709 La Tijera Blvd #500 Los Angeles CA 90045-2017 Ph: (310) 674-1970 | Randy Hawkins, M.d., Inc 644 E Regent St #200 Inglewood CA 90301-1433 Ph: (310) 674-1970 |
| NPI Number | 1225357155 |
|---|---|
| Provider Enumeration Date | 05/17/2010 |
| Last Update Date | 05/17/2010 |
| Medicare PECOS PAC ID | 6103955950 |
|---|---|
| Medicare Enrollment ID | O20100603000683 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225357155 | NPI | - | NPPES |
| 00G493540 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G49354 (California) | Primary |
| 207RP1001X | Internal Medicine - Pulmonary Disease | G49354 (California) | Secondary |
| Provider Name | Randy W Hawkins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760580971 PECOS PAC ID: 9234195652 Enrollment ID: I20100603000731 |
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