Jackson Randolph, MD
NPI #1063040970 in San Luis Obispo, California
Provider Information
- NPI Number
- 1063040970
- Entity Type
- Individual
- Name
- Jackson Randolph, MD
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Otolaryngology
- Credential
- MD
- Enumeration Date
- Mar 28, 2020
- Last Updated
- Jun 14, 2025
Practice Location
- Address
- 35 CASA ST STE 130
- City
- San Luis Obispo
- State
- California
- ZIP Code
- 93405-1887
- Phone
- (805) 541-1422
Specialties & Taxonomy Codes
| Specialty |
|---|
| Otolaryngology |
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