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NPI Code Detail

MEDICARE: DR. ANDREW KEN STRIDIRON MD

MEDICARE:  DR. ANDREW KEN STRIDIRON  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
1208000000XPediatrics Physician25507HI
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1598414203
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW KEN STRIDIRON MD
Provider Business Mailing Address
First Line : 2516 STOCKTON BLVD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95817-2208
Country : US
Telephone Number : 916-734-2428
Fax Number :
Provider Business Practice Location Address
First Line : 2516 STOCKTON BLVD DEPT OF
Second Line :
City : SACRAMENTO
State : CA
Zip : 95817-2208
Country : US
Telephone Number : 916-734-2428
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2022
Last Update Date : 01/04/2026

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Directions to “ DR. ANDREW KEN STRIDIRON MD” Practice Location

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