Provider Demographics
NPI:1942592746
Name:ATOIAN, ANDRE GREGORY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:GREGORY
Last Name:ATOIAN
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 1:1559 WINONA BLVD APT 3B
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5031
Mailing Address - Country:US
Mailing Address - Phone:310-951-8400
Mailing Address - Fax:
Practice Address - Street 1:1559 WINONA BLVD APT 3B
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5031
Practice Address - Country:US
Practice Address - Phone:310-951-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA107342207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology