Provider Demographics
NPI:1750481651
Name:NANGALAMA, ANDREW W (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:W
Last Name:NANGALAMA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1425 CROCKER DR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-3789
Mailing Address - Country:US
Mailing Address - Phone:916-549-3973
Mailing Address - Fax:916-380-5841
Practice Address - Street 1:9490 MADISON AVE STE 200
Practice Address - Street 2:
Practice Address - City:ORANGEVALE
Practice Address - State:CA
Practice Address - Zip Code:95662-4983
Practice Address - Country:US
Practice Address - Phone:916-621-2000
Practice Address - Fax:916-380-5841
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2024-11-19
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Provider Licenses
StateLicense IDTaxonomies
CAA62253207R00000X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine