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General NPI Number Information
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NPI Number | 1740868926
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Entity Type | Organization
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Legal Business Name | K ANDRUSKA MD PHD PC
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Dates
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Enumeration Date | 03/30/2021
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Last Update Date | 04/19/2021
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Provider Practice Location Address
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Address Line | 825 POLLARD RD STE 100
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City | LOS GATOS
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State | CA
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Zip | 95032-1435
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Country | US
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Telephone | 650-484-0440
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Fax | 650-484-0668
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Provider Business Mailing Address
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Address Line | PO BOX 391344
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94039-1344
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Country | US
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Telephone | 650-484-0440
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KRISTIN ANDRUSKA
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Credential | MD, PHD
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Telephone | 650-484-0440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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