Provider Demographics
NPI:1326482225
Name:ANDREW R. MCINTOSH, M.D. INC.
Entity Type:Organization
Organization Name:ANDREW R. MCINTOSH, M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCINTOSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-249-3780
Mailing Address - Street 1:30131 TOWN CENTER DR
Mailing Address - Street 2:SUITE 195
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-2034
Mailing Address - Country:US
Mailing Address - Phone:949-249-3780
Mailing Address - Fax:949-249-3730
Practice Address - Street 1:30131 TOWN CENTER DR
Practice Address - Street 2:SUITE 195
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-2034
Practice Address - Country:US
Practice Address - Phone:949-249-3780
Practice Address - Fax:949-249-3730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA850552472E0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEGGroup - Single Specialty