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Randy Allen Beddoe

Family Medicine

Allopathic & Osteopathic Physicians

1524 W Lacey Blvd, Suite 206, Hanford, CA 93230-5965

PECOS Enrollment

This provider is enrolled in PECOS as RANDY BEDDOE.

Based on the most recent information from CMS, provider Randy Allen Beddoe is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:12 AM.

Profile Details

Provider ID
1740267426
Provider Type
Individual
Full Name
Beddoe, Randy Allen
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
12/23/2005
Last Updated
1/23/2013

Contact Information

Practice Location

1524 W Lacey Blvd, Suite 206, Hanford, CA 93230-5965

(559) 583-4662

(559) 583-4684

Mailing Location

1524 W Lacey Blvd, Suite 206, Hanford, CA 93230-5965

(559) 583-4662

(559) 583-4684

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License G57182 California

Provider Identifiers

ID	Description	Issuer
ID G57182	Description Other	Issuer CALIF. LICENSE California

Randy Allen Beddoe

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Tomlinson Medical Associates

Daniel L Engeberg, Md, Inc.

Renteria, Adalberto

Nairod Nerak Inc.

Melashenko, Kenneth W

Hernandez Duran, Jose Javier

Hanford Community Medical Center

Kaur, Mandeep

Patel, Vimal B

Eddins, Paul