Healthcare Provider Details

I. General information

NPI: 1891808622
Provider Name (Legal Business Name): ANDREW S GIVNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HOSPITAL CIR
WESTMINSTER CA
92683-3910
US

IV. Provider business mailing address

1601 BARTON RD #3201
REDLANDS CA
92373-5306
US

V. Phone/Fax

Practice location:
  • Phone: 714-893-4541
  • Fax: 818-587-2493
Mailing address:
  • Phone: 909-435-6955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA95678
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: