Healthcare Provider Details

I. General information

NPI: 1205413978
Provider Name (Legal Business Name): ANDREW DAEDLER MD, MAUB
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 N BELLFLOWER BLVD
LONG BEACH CA
90815-3126
US

IV. Provider business mailing address

2110 N BELLFLOWER BLVD
LONG BEACH CA
90815-3126
US

V. Phone/Fax

Practice location:
  • Phone: 562-346-2222
  • Fax: 562-546-8210
Mailing address:
  • Phone: 562-346-2222
  • Fax: 562-546-8210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA195273
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: