Provider Demographics
NPI:1437426285
Name:TALAI, RANDY (MS, DC)
Entity type:Individual
Prefix:DR
First Name:RANDY
Middle Name:
Last Name:TALAI
Suffix:
Gender:F
Credentials:MS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3250 WILSHIRE BLVD
Mailing Address - Street 2:#400
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-1577
Mailing Address - Country:US
Mailing Address - Phone:818-610-9339
Mailing Address - Fax:
Practice Address - Street 1:3250 WILSHIRE BLVD
Practice Address - Street 2:#400
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-1577
Practice Address - Country:US
Practice Address - Phone:818-610-9339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26660111NN1001X
133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
No133N00000XDietary & Nutritional Service ProvidersNutritionist