Provider Demographics
NPI:1801873575
Name:BRASCH, ANDREW JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JOSEPH
Last Name:BRASCH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6283 CLARK RD
Mailing Address - Street 2:SUITE 16
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-4100
Mailing Address - Country:US
Mailing Address - Phone:530-877-2578
Mailing Address - Fax:
Practice Address - Street 1:6283 CLARK RD
Practice Address - Street 2:SUITE 16
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-4100
Practice Address - Country:US
Practice Address - Phone:530-877-2578
Practice Address - Fax:530-877-0108
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-23
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA425402084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA29600Medicare UPIN