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NPI Code Detail

MEDICARE: DR. ANDREW G. MONROY M.D.

MEDICARE:  DR. ANDREW G. MONROY  M.D.
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
12081P2900XPain Medicine (Physical Medicine & Rehabilitation) PhysicianA69536CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17962591OTHERAETNA
20214363OTHERWASHINGTON STATE DOL
3ZZZ624728ZOTHERTRIWEST
400A695360OTHERCABLUE SHIELD OF CA
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
600A695360OTHERSBHA PIN
711435679OTHERCACAQH ID NUMBER
8605890700OTHERUSDL
9RHC149609OTHERCAX-RAY SUPERVISOR & OPERATOR

General Provider Information

NPI Number : 1518957539
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW G. MONROY M.D.
Provider Business Mailing Address
First Line : PO BOX 160
Second Line :
City : ARROYO GRANDE
State : CA
Zip : 93421-0160
Country : US
Telephone Number : 805-473-3705
Fax Number : 805-473-4832
Provider Business Practice Location Address
First Line : 310 S HALCYON RD
Second Line : SUITE 106
City : ARROYO GRANDE
State : CA
Zip : 93420-3872
Country : US
Telephone Number : 805-473-3705
Fax Number : 805-473-4832
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2005
Last Update Date : 01/12/2009

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