MEDICARE: MATTHEW C MCANDREW MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	D0063196	MD
2	208M00000X	Hospitalist Physician	ME169725	FL
3	208M00000X	Hospitalist Physician	C54721	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	FK220Z	OTHER	CA	MEDICARE

General Provider Information

NPI Number	:	1215928197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW C MCANDREW MD

Provider Business Mailing Address
First Line	:	PO BOX 254869
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95865-4869
Country	:	US
Telephone Number	:	916-854-6975
Fax Number	:

Provider Business Practice Location Address
First Line	:	2340 CLAY ST
Second Line	:	3RD FLOOR
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-1932
Country	:	US
Telephone Number	:	916-854-6975
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	08/15/2024

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