Provider Demographics
NPI:1407080799
Name:GARLAND, ANDREA T (MD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:T
Last Name:GARLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5821 JAMESON CT
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-0820
Mailing Address - Country:US
Mailing Address - Phone:916-486-0411
Mailing Address - Fax:916-486-0946
Practice Address - Street 1:5821 JAMESON CT
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0820
Practice Address - Country:US
Practice Address - Phone:916-486-0411
Practice Address - Fax:916-486-8112
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA115655207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARA115655OtherMEDICAL STATE LICENSE