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General NPI Number Information
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NPI Number | 1043402373
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Entity Type | Individual
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Provider Name | ANDREW D RENDOFF P.A.
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Gender | Male
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Dates
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Enumeration Date | 08/10/2007
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 12315 N VISTOSO PARK RD
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City | ORO VALLEY
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State | AZ
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Zip | 85755-5819
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Country | US
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Telephone | 520-544-9700
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Fax | 520-618-6060
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Provider Business Mailing Address
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Address Line | PO BOX 31630
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City | TUCSON
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State | AZ
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Zip | 85751-1630
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Country | US
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Telephone | 520-784-6200
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Fax | 520-784-6109
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | T01462
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 9077
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 2017012741
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 9077
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License Number State | AZ
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