Provider Demographics
NPI:1811079338
Name:SELTZER, ANDREW GARY (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:GARY
Last Name:SELTZER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 3146
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90408-3146
Mailing Address - Country:US
Mailing Address - Phone:714-296-3988
Mailing Address - Fax:310-393-3016
Practice Address - Street 1:14600 SHERMAN WAY
Practice Address - Street 2:SUITE 250
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2283
Practice Address - Country:US
Practice Address - Phone:818-212-2223
Practice Address - Fax:818-212-2224
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2014-04-03
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Provider Licenses
StateLicense IDTaxonomies
CAA86140207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA86140BMedicare PIN