Doctor Name: | RANDY KENT KNUTZON |
NPI Number: | 1730185620 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | A46090 |
Business Practice Address: | 1640 E Roseville Pkwy Ste 100 Roseville, CA - 956613988 |
Business Phone Number: | 9167842277 |
Business Fax Number: | 9169321104 |
Mailing Address: | 10470 Old Placerville Rd, Suite 100 SACRAMENTO |
State: | CA |
Postal Code: | 958272539 |
Phone Number: | 8004700071 |
Fax Number: | |
NPI Enumeration Date: | 06/24/2005 |
NPI Last Update Date: | 06/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085B0100X |
License Number: | A46090 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Body Imaging |
Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |