Healthcare Provider Details

I. General information

NPI: 1821222852
Provider Name (Legal Business Name): ANDREA A D'AURIA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2009
Last Update Date: 05/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E VALLEY PKWY
ESCONDIDO CA
92025-3048
US

IV. Provider business mailing address

555 E VALLEY PKWY
ESCONDIDO CA
92025-3048
US

V. Phone/Fax

Practice location:
  • Phone: 760-739-3030
  • Fax:
Mailing address:
  • Phone: 760-739-3030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number20A10819
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number20A10819
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: