Provider Demographics
NPI:1649528704
Name:ZANDONA, ANDRE NASCIMENTO
Entity type:Individual
Prefix:MR
First Name:ANDRE
Middle Name:NASCIMENTO
Last Name:ZANDONA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 NEVADA ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-2133
Mailing Address - Country:US
Mailing Address - Phone:858-952-9368
Mailing Address - Fax:
Practice Address - Street 1:145 NEVADA ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-2133
Practice Address - Country:US
Practice Address - Phone:858-952-9368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program