Provider Demographics
NPI:1073611778
Name:KOVACS, ANDREA A (MD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:A
Last Name:KOVACS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANDREA KOVACS
Other - Middle Name:
Other - Last Name:LOOMIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1000 S. FREEMONT AVENUE, UNIT 62, SUITE 10220
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803
Mailing Address - Country:US
Mailing Address - Phone:626-457-5820
Mailing Address - Fax:626-457-4003
Practice Address - Street 1:2010 ZONAL AVENUE, MEDICAL VILLAGE
Practice Address - Street 2:OPD 5 WEST
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:323-226-2200
Practice Address - Fax:323-226-3971
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG414282080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G414280Medicaid
CAWG41428BMedicare ID - Type Unspecified
CAA89725Medicare UPIN