Healthcare Provider Details

I. General information

NPI: 1346044146
Provider Name (Legal Business Name): ANDREW CLINE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E 13TH ST
MERCED CA
95341-6211
US

IV. Provider business mailing address

301 E 13TH ST
MERCED CA
95341-6211
US

V. Phone/Fax

Practice location:
  • Phone: 209-819-9502
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-RPDGUY
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: