Provider Demographics
NPI:1346720851
Name:HEBBLETHWAITE, ANDREW ALLAN (RCP, RRT)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:ALLAN
Last Name:HEBBLETHWAITE
Suffix:
Gender:M
Credentials:RCP, RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 N EDGEMONT ST FL 4
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5209
Mailing Address - Country:US
Mailing Address - Phone:323-783-1770
Mailing Address - Fax:
Practice Address - Street 1:1505 N EDGEMONT ST FL 4
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5209
Practice Address - Country:US
Practice Address - Phone:323-783-1770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36636227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered