Provider Demographics
NPI:1922041904
Name:CIES, W ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:W
Middle Name:ANDREW
Last Name:CIES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 NEWPORT CENTER DR #404
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7687
Mailing Address - Country:US
Mailing Address - Phone:949-640-2023
Mailing Address - Fax:949-640-7182
Practice Address - Street 1:400 NEWPORT CENTER DR #404
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7687
Practice Address - Country:US
Practice Address - Phone:949-640-2023
Practice Address - Fax:949-640-7182
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG24340207W00000X, 156FX1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0526290001Medicare NSC
CAG24340Medicare UPIN