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General NPI Number Information
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NPI Number | 1861962516
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Entity Type | Organization
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Legal Business Name | ANDREW IMPARATO INC
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Dates
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Enumeration Date | 11/26/2018
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Last Update Date | 11/26/2018
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Provider Practice Location Address
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Address Line | 12401 WASHINGTON BLVD
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City | WHITTIER
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State | CA
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Zip | 90602-1006
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Country | US
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Telephone | 562-698-0811
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Fax |
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Provider Business Mailing Address
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Address Line | 510 PEBBLE BEACH PL
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City | FULLERTON
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State | CA
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Zip | 92835-2728
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Country | US
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Telephone | 562-556-9595
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Fax |
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Authorized Official
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Title or Position | MD/PRESIDENT
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Name | ANDREW JOHN IMPARATO
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Credential | M.D.
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Telephone | 562-556-9595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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