Provider Demographics
NPI:1205937703
Name:ANDO, STEVEN H (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:H
Last Name:ANDO
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 1:23388 MULHOLLAND DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2733
Mailing Address - Country:US
Mailing Address - Phone:818-556-2700
Mailing Address - Fax:818-563-9469
Practice Address - Street 1:4323 W RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4044
Practice Address - Country:US
Practice Address - Phone:818-556-2700
Practice Address - Fax:818-563-9469
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG45707207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G457070OtherBLUE SHIELD
CAWG45707DMedicare ID - Type Unspecified
CAWG45707EMedicare ID - Type Unspecified
A50156Medicare UPIN
CA00G457070OtherBLUE SHIELD
CAWG45707CMedicare ID - Type Unspecified
CAWG45707FMedicare ID - Type Unspecified