Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Randy Steven Yergenson

Individual provider Medical Physician Assistant · NPI 1235510504

Randy Steven Yergenson is a Physician Assistant in Banning, California. Qualified in 2015, 11 years ago. Practices with Beaver Medical Group P C, a 255-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
11
Licensed in
CA
In the registry since
2015
Specialties on file
2

Practice location Address checks out

5957 W Ramsey St
Banning, CA 92220-3058
Phone: (951) 845-0313
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 52591 (CA)
Medical Physician Assistant Taxonomy 363AM0700X (CA)

Record details

NPI number1235510504
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 12, 2015
Last updated in NPPESSeptember 8, 2025
Certification dateSeptember 8, 2025
Mailing addressPo Box 35380, Las Vegas, NV 89133-5380

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Beaver Medical Group P C — 255 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Banning