Provider Demographics
NPI:1073144044
Name:ANDRYJOWICZ, ADRIAN ESTEBAN
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:ESTEBAN
Last Name:ANDRYJOWICZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 GETTYSBURG CIR
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-2939
Mailing Address - Country:US
Mailing Address - Phone:310-488-6429
Mailing Address - Fax:
Practice Address - Street 1:702 GETTYSBURG CIR
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-2939
Practice Address - Country:US
Practice Address - Phone:310-488-6429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant