Provider Demographics
NPI:1144275264
Name:MENDELSSOHN, ANDREA (MD, FACOG, FABIHM)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:MENDELSSOHN
Suffix:
Gender:F
Credentials:MD, FACOG, FABIHM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6606
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-0606
Mailing Address - Country:US
Mailing Address - Phone:510-529-6659
Mailing Address - Fax:
Practice Address - Street 1:970 DEWING AVE STE 203
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4260
Practice Address - Country:US
Practice Address - Phone:925-299-9001
Practice Address - Fax:925-299-9018
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75537207V00000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A755370Medicaid
CAH53047Medicare UPIN
CA00A755371Medicare ID - Type Unspecified