Provider Demographics
NPI:1386849974
Name:HORODNER, ANDREW GABRIEL (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:GABRIEL
Last Name:HORODNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 N PROSPECT AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-3040
Mailing Address - Country:US
Mailing Address - Phone:310-750-3300
Mailing Address - Fax:
Practice Address - Street 1:514 N PROSPECT AVE FL 4
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-3040
Practice Address - Country:US
Practice Address - Phone:310-750-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81801207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology