| Dr Kamala Joy Randolph, MD | |
| 
					1427 Nw Flanders St Ste A, Portland, OR 97209-2646  | |
| (503) 972-0235 | |
| (971) 216-4964 | 
| Full Name | Dr Kamala Joy Randolph | 
|---|---|
| Gender | Female | 
| Speciality | Internal Medicine | 
| Location | 1427 Nw Flanders St Ste A, Portland, Oregon | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1801002548 | NPI | - | NPPES | 
| 8482374 | Medicaid | WA | |
| 500648424 | Medicaid | OR | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207R00000X | Internal Medicine | MD00048113 (Washington) | Secondary | 
| 208000000X | Pediatrics | MD00048113 (Washington) | Secondary | 
| 207R00000X | Internal Medicine | MD28882 (Oregon) | Primary | 
| Entity Name | Clinicops Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1275821266 PECOS PAC ID: 9739343245 Enrollment ID: O20120613000647  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Kamala Joy Randolph, MD 2459 Se Tualatin Valley Hwy # 413, Hillsboro, OR 97123-7919 Ph: (503) 972-0235  | Dr Kamala Joy Randolph, MD 1427 Nw Flanders St Ste A, Portland, OR 97209-2646 Ph: (503) 972-0235  | 
Salona Shrestha, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 4805 Ne Glisan St, Portland, OR 97213 Phone: 503-215-2392  | |
Dr. Emmanuel Trungtoan Tavan, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2800 N Vancouver Ave, Suite 230, Portland, OR 97227 Phone: 503-413-2901  | |
Ginevra Lois Liptan, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 6400 Sw Canyon Ct, Ste 100, Portland, OR 97221 Phone: 503-477-9616 Fax: 503-477-9808  | |
Donald Richard Sullivan, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Uhn67, Portland, OR 97239 Phone: 503-494-6949  | |
Dr. Victor Nguyen Pham, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 9205 Sw Barnes Rd, Portland, OR 97225 Phone: 503-216-2906  | |
Richa Uppal, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1849 Nw Kearney St Ste 200, Portland, OR 97209 Phone: 971-229-4545 Fax: 503-966-2427  | |
Reem Hasan, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Ppv 350, Portland, OR 97239 Phone: 503-494-8562  |