Healthcare Provider Details

I. General information

NPI: 1306408505
Provider Name (Legal Business Name): ANDREW BIERMAN FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2019
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GOTTSCHALK MEDICAL PLAZA 1 MEDICAL PLAZA DRIVE
IRVINE CA
92697-4219
US

IV. Provider business mailing address

6010 HIDDEN VALLEY RD STE 200
CARLSBAD CA
92011-4219
US

V. Phone/Fax

Practice location:
  • Phone: 949-824-8600
  • Fax:
Mailing address:
  • Phone: 760-631-3000
  • Fax: 760-631-3016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95011909
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: