Provider Demographics
NPI:1558441428
Name:WIESENTHAL, ANDREW MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:MICHAEL
Last Name:WIESENTHAL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:555 MISSION ST
Mailing Address - Street 2:C/O DELOITTE CONSULTING, LLP
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94105-0920
Mailing Address - Country:US
Mailing Address - Phone:415-783-5849
Mailing Address - Fax:415-783-9366
Practice Address - Street 1:555 MISSION ST
Practice Address - Street 2:C/O DELOITTE CONSULTING, LLP
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-0920
Practice Address - Country:US
Practice Address - Phone:415-783-5849
Practice Address - Fax:415-783-9366
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2018-01-23
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Provider Licenses
StateLicense IDTaxonomies
CAG858512080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases