Healthcare Provider Details

I. General information

NPI: 1366400384
Provider Name (Legal Business Name): ANDREW CHERNER ENGLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 11/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 BALDWIN AVE
SAN MATEO CA
94401-3915
US

IV. Provider business mailing address

290 BALDWIN AVE
SAN MATEO CA
94401-3915
US

V. Phone/Fax

Practice location:
  • Phone: 650-343-4597
  • Fax: 650-343-3402
Mailing address:
  • Phone: 650-343-4597
  • Fax: 650-343-3402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberG52230
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: