Provider Demographics
NPI:1932131257
Name:KATZ, ANDREW JAY (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:JAY
Last Name:KATZ
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 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:916-861-1451
Mailing Address - Fax:
Practice Address - Street 1:8220 WYMARK DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95757-0000
Practice Address - Country:US
Practice Address - Phone:916-667-0600
Practice Address - Fax:916-683-0232
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81324208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics