Healthcare Provider Details

I. General information

NPI: 1316973811
Provider Name (Legal Business Name): ANDREW CHRISTOPHER VERNEUIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 04/05/2021
Certification Date: 04/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 SQUALICUM PKWY #203
BELLINGHAM WA
98225-1892
US

IV. Provider business mailing address

2940 SQUALICUM PKWY STE 203
BELLINGHAM WA
98225-1892
US

V. Phone/Fax

Practice location:
  • Phone: 949-364-4361
  • Fax: 949-364-4495
Mailing address:
  • Phone: 949-364-4361
  • Fax: 949-364-4495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA65142
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD00047524
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: