Healthcare Provider Details

I. General information

NPI: 1174543318
Provider Name (Legal Business Name): ANDREW SAXON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 05/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MEDICAL PLAZA #365,530,420,120
LOS ANGELES CA
90095
US

IV. Provider business mailing address

10833 LE CONTE AVE 52-262 CHS, DEPT MEDICINE, UCLA MEDICAL SCHOOL
LOS ANGELES CA
90095-1690
US

V. Phone/Fax

Practice location:
  • Phone: 310-794-9718
  • Fax:
Mailing address:
  • Phone: 310-206-8050
  • Fax: 310-267-0090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberG24948
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: