Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD460149 | PA |
NPI | 1134472939 |
---|---|
Provider Name | Andrew Kirk Battenberg |
First Address | Redondo Beach, CA 90277-5930 |
Second Address | Torrance, CA 90502-2004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2012 |
Last Update Date | 22/12/2021 |