Healthcare Provider Details

I. General information

NPI: 1578520003
Provider Name (Legal Business Name): ANDREUX W CHERNNE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 05/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 ROSSMOOR PKWY
WALNUT CREEK CA
94595-2501
US

IV. Provider business mailing address

DEPT 34929 P.O. BOX 39000
SAN FRANCISCO CA
94139-0001
US

V. Phone/Fax

Practice location:
  • Phone: 925-947-3393
  • Fax: 925-947-3396
Mailing address:
  • Phone: 925-952-2828
  • Fax: 925-952-2850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA88257
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA88257
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: