Healthcare Provider Details

I. General information

NPI: 1144275264
Provider Name (Legal Business Name): ANDREA MENDELSSOHN MD, FACOG, FABIHM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 DEWING AVE STE 203
LAFAYETTE CA
94549-4260
US

IV. Provider business mailing address

PO BOX 6606
ALBANY CA
94706-0606
US

V. Phone/Fax

Practice location:
  • Phone: 925-299-9001
  • Fax: 925-299-9018
Mailing address:
  • Phone: 510-529-6659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA75537
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberA75537
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: