Provider Demographics
NPI:1518957539
Name:MONROY, ANDREW G (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:G
Last Name:MONROY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93421-0160
Mailing Address - Country:US
Mailing Address - Phone:805-473-3705
Mailing Address - Fax:805-473-4832
Practice Address - Street 1:310 S HALCYON RD
Practice Address - Street 2:SUITE 106
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-3872
Practice Address - Country:US
Practice Address - Phone:805-473-3705
Practice Address - Fax:805-473-4832
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA695362081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
7962591OtherAETNA
0214363OtherWASHINGTON STATE DOL
ZZZ624728ZOtherTRIWEST
CA00A695360OtherBLUE SHIELD OF CA
CA00A695360Medicaid
00A695360OtherSBHA PIN
CA11435679OtherCAQH ID NUMBER
605890700OtherUSDL
CARHC149609OtherX-RAY SUPERVISOR & OPERATOR
CARHC149609OtherX-RAY SUPERVISOR & OPERATOR
0214363OtherWASHINGTON STATE DOL