Provider Demographics
NPI:1447435813
Name:ALL DESERT RESPIRATORY
Entity type:Organization
Organization Name:ALL DESERT RESPIRATORY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:CRT
Authorized Official - Phone:661-974-8009
Mailing Address - Street 1:42247 12TH STREET WEST #115
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-7033
Mailing Address - Country:US
Mailing Address - Phone:661-974-8009
Mailing Address - Fax:661-974-8305
Practice Address - Street 1:42247 12TH STREET WEST
Practice Address - Street 2:SUITE 115
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2313
Practice Address - Country:US
Practice Address - Phone:661-974-8009
Practice Address - Fax:661-974-8305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-04
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45053332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5787670001Medicare NSC