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Provider Information for 1942345251

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. RANDAL STUART ELLOWAY DDS

Gender: MALE

Individual NPI: 1942345251

Calendar   Last Updated:  2010-02-25
  Certification Date: 

Details

Name Value
NPI 1942345251
Enumeration Date 2007-02-21
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 2426 S MAIN ST RED BLUFF
RED BLUFF, CA 96080-4337
United States

Phone: 530-527-6777 | Fax: 530-527-6551
View Map External Link
Primary Practice Address 2426 S MAIN ST
RED BLUFF, CA 96080-4337
United States

Phone: 530-527-6777 | Fax: 530-527-6551
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice CA 40581