Provider Demographics
NPI:1770307647
Name:HALL, ANDREW ARTHUR I
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:ARTHUR
Last Name:HALL
Suffix:I
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 1:125 N AVENUE 56 APT 3
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-4146
Mailing Address - Country:US
Mailing Address - Phone:760-567-3852
Mailing Address - Fax:
Practice Address - Street 1:8420 BEVERLY RD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-2203
Practice Address - Country:US
Practice Address - Phone:760-567-3852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical