Active NPI
Andrew Lie, DVM
- Veterinarian
- San Rafael, CA
National Provider Identifier
1346586302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Veterinarian
- License
- 16588
- Practice address
- 820 D St
San Rafael, CA 94901-2814 - Phone
- (415) 456-4463
- Fax
- (415) 456-3786
- NPI assigned
- Dec 19, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Veterinarian | 174M00000X | 16588 | CA | Primary |
Addresses
Primary practice location
820 D St
San Rafael, CA 94901-2814
Mailing address
820 D St
San Rafael, CA 94901-2814
Phone (415) 456-4463
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355875200000",
"number": "1346586302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 D ST",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949012814",
"telephone_number": "415-456-4463",
"fax_number": "415-456-3786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 D ST",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949012814",
"telephone_number": "415-456-4463",
"fax_number": "415-456-3786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIE",
"first_name": "ANDREW",
"credential": "DVM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-12-19",
"last_updated": "2012-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "174M00000X",
"taxonomy_group": "",
"desc": "Veterinarian",
"state": "CA",
"license": "16588",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.