Provider Demographics
NPI:1861441594
Name:PUMERANTZ, ANDREW STEVEN (DO)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:STEVEN
Last Name:PUMERANTZ
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:795 E 2ND ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-2007
Mailing Address - Country:US
Mailing Address - Phone:909-706-3779
Mailing Address - Fax:909-865-2955
Practice Address - Street 1:795 E 2ND ST
Practice Address - Street 2:SUITE 4
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-2007
Practice Address - Country:US
Practice Address - Phone:909-706-3779
Practice Address - Fax:909-865-2955
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2012-02-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY180755207RI0200X
CA20A9786207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY95Z67Medicare UPIN