Provider Demographics
NPI:1194838516
Name:ALONGI, ANDREW J (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:ALONGI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6255 SPRUCE LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-3345
Mailing Address - Country:US
Mailing Address - Phone:619-205-1485
Mailing Address - Fax:619-205-1406
Practice Address - Street 1:2345 E 8TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2800
Practice Address - Country:US
Practice Address - Phone:619-779-7905
Practice Address - Fax:619-779-7906
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG19454207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A40654Medicare UPIN
CA00G194540Medicare ID - Type Unspecified