Provider Demographics
NPI:1750481651
Name:NANGALAMA, ANDREW W (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:W
Last Name:NANGALAMA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1425 CROCKER DR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-3789
Mailing Address - Country:US
Mailing Address - Phone:916-549-3973
Mailing Address - Fax:916-380-5841
Practice Address - Street 1:915 HIGHLAND POINTE DR STE 250
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-5421
Practice Address - Country:US
Practice Address - Phone:916-621-2000
Practice Address - Fax:916-380-5841
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2023-04-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA62253207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine