Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | E2484 | CA |
NPI | 1043345416 |
---|---|
Provider Name | Robin W Andrews |
First Address | Laguna Hills, CA 92653-3616 |
Second Address | Laguna Hills, CA 92653-3616 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
GRE000020 | (05) | CA |
T19203 | (02) | CA |