Individual provider Active NPI

Adrian Esteban Andryjowicz, PA

  • Physician Assistant
  • Rancho Cucamonga, CA
National Provider Identifier
1073144044
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
57915 Issued in CA
Practice address
8439 White Oak Ave Ste 103
Rancho Cucamonga, CA 91730-3860
Phone
(818) 337-6488
Fax
(818) 350-4784
NPI assigned
Jan 29, 2020
Last updated
Oct 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 57915 CA Primary

Addresses

Primary practice location

8439 White Oak Ave Ste 103
Rancho Cucamonga, CA 91730-3860

Mailing address

202 S Raymond Ave Unit 405
Pasadena, CA 91105-4117
Phone (310) 488-6429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200901002983 CA Practitioner - Physician Assistant 1355768359 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
57915CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
California Mobile Medical Group Inc PastSince Nov 19, 2023 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791936000000",
    "number": "1073144044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 S RAYMOND AVE UNIT 405",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911054117",
            "telephone_number": "310-488-6429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8439 WHITE OAK AVE STE 103",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303860",
            "telephone_number": "818-337-6488",
            "fax_number": "818-350-4784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRYJOWICZ",
        "first_name": "ADRIAN",
        "middle_name": "ESTEBAN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-29",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.