Provider Demographics
NPI:1750316709
Name:ANDREWS, TONY G (MD)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:G
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15195 NATIONAL AVE
Mailing Address - Street 2:206
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2631
Mailing Address - Country:US
Mailing Address - Phone:408-358-1234
Mailing Address - Fax:408-358-2202
Practice Address - Street 1:15195 NATIONAL AVE
Practice Address - Street 2:206
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2631
Practice Address - Country:US
Practice Address - Phone:408-358-1234
Practice Address - Fax:408-358-2202
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC351420207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA35856Medicare UPIN
CA00C351420Medicare ID - Type Unspecified