Healthcare Provider Details

I. General information

NPI: 1932360880
Provider Name (Legal Business Name): ANDRE PAUL MARSHALL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 N BEDFORD DR STE 206
BEVERLY HILLS CA
90210-4350
US

IV. Provider business mailing address

435 N BEDFORD DR STE 206
BEVERLY HILLS CA
90210-4350
US

V. Phone/Fax

Practice location:
  • Phone: 424-437-3200
  • Fax: 424-328-5898
Mailing address:
  • Phone: 424-437-3200
  • Fax: 424-328-5898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA155013
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: