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NPI Code Detail

MEDICARE: ANDREA MCFADDEN PA-C

MEDICARE:   ANDREA  MCFADDEN  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA13192CA

General Provider Information

NPI Number : 1295072676
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA MCFADDEN PA-C
Provider Business Mailing Address
First Line : 5675 TANNER RIDGE AVE
Second Line :
City : WESTLAKE VILLAGE
State : CA
Zip : 91362-5236
Country : US
Telephone Number : 818-706-7714
Fax Number :
Provider Business Practice Location Address
First Line : 1950 E LOS ANGELES AVE
Second Line :
City : SIMI VALLEY
State : CA
Zip : 93065-3503
Country : US
Telephone Number : 805-306-1440
Fax Number : 805-306-0758
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2013
Last Update Date : 01/06/2013

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Directions to “ ANDREA MCFADDEN PA-C” Practice Location

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