Provider Demographics
NPI:1073254587
Name:ANDREW M FOX MD INC A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:ANDREW M FOX MD INC A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:M
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-616-4429
Mailing Address - Street 1:4849 VAN NUYS BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2122
Mailing Address - Country:US
Mailing Address - Phone:818-616-4429
Mailing Address - Fax:818-616-4829
Practice Address - Street 1:4849 VAN NUYS BLVD STE 203
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2122
Practice Address - Country:US
Practice Address - Phone:818-616-4429
Practice Address - Fax:818-616-4829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty