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MR. RANDALL S FORTUNA MD NPI 1285607986


NPI Information

NPI: 1285607986
Provider Name: MR. RANDALL S FORTUNA, MD
Classification: Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
11234 ANDERSON ST # 7100
LOMA LINDA, CA
ZIP 92354
Phone: (909) 558-4200
Get Directions

MR. Randall S Fortuna, MD is a thoracic surgery cardiothoracic vascular surgery in Loma Linda, CA with 30 years of experience. The provider is a thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. MR. Randall S Fortuna, MD NPI is 1285607986. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduation Year:1994

The provider's business location address is:

11234 ANDERSON ST # 7100
LOMA LINDA, CA
ZIP 92354-804
Phone: (909) 558-4200
Fax: (909) 558-2401

The NPI 1285607986 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/12/2006 and was last updated on 10/31/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12086S0129XSurgeryVascular Surgery036109764ILLINOISNo
22086S0129XSurgeryVascular Surgery036-109764ILLINOISNo
3208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)036109764ILLINOISNo
4208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)49534ARIZONANo
5208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)A68643CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
107215075OTHERILLINOISBLUE SHIELD PROVIDER NUMB
2036109764MEDICAIDILLINOIS
3IL0138OTHERILLINOISJOHN DEERE
4934932MEDICAIDARIZONA
5P00038024/CA5138OTHERILLINOISRAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.