person
Randall Alan Roark, NP
Family Nurse Practitioner in Imperial Beach, California
NPI 1447312178

Randall Alan Roark is a Family Nurse Practitioner based in Imperial Beach, CA and is specialized in Family. Randall Alan Roark practices in Imperial Beach, CA and has the professional credentials of NP. The NPI Number for Randall Alan Roark is 1447312178 and holds a License No. 568148 (California).

The current practice location address for Randall Alan Roark is 949 Palm Ave, Imperial Beach, CA and can be reached out via phone at 619-429-3733 and via fax at 619-628-5550.

Location: 949 Palm Ave, Imperial Beach, CA, 91933-0459
person
Provider Profile Details
NPI Number
1447312178
Provider Name
Randall Alan Roark
Credential
NP
Provider Entity Type
Individual
Gender
Male
Address
949 Palm Ave, Imperial Beach, CA, 91933-0459
Phone Number
619-429-3733
Fax Number
619-628-5550
Provider Enumeration Date
12/16/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
949 Palm Ave
City
State
Zip
91932
Phone Number
619-429-3733
Fax Number
619-628-5550
person
Provider Business Mailing Address Details
Address
949 Palm Ave
City
State
Zip
91932
Phone Number
619-429-3733
Fax Number
619-628-5550
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
License No.
15996 (California)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
568148 (California)
Definition
Definition to come...
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