Organization Active NPI

Andre Andresian,M.D., F.a.C.C.

  • Cardiovascular Disease Physician
  • Covina, CA
National Provider Identifier
1366640096
Registry record updated Feb 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A25075 Issued in CA
Legal business name
ANDRE ANDRESIAN,M.D., F.A.C.C.
Practice address
420 N 4TH Ave
Covina, CA 91723-1835
Phone
(626) 331-6663
Fax
(626) 339-8132
NPI assigned
Jul 3, 2007
Last updated
Feb 11, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2011

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

Authorized official

Name
Ms. Susanne Andresian
Title
RN
Phone
(626) 331-6663

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A25075 CA Primary

Addresses

Primary practice location

420 N 4TH Ave
Covina, CA 91723-1835

Mailing address

420 N 4TH Ave
Covina, CA 91723-1835
Phone (626) 331-6663

National Provider Directory

National Provider Directory

Locations

420 N 4th Ave
Covina, CA 91723
Phone (626) 331-6663

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297382400000",
    "number": "1366640096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 N 4TH AVE",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231835",
            "telephone_number": "626-331-6663",
            "fax_number": "626-339-8132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N 4TH AVE",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231835",
            "telephone_number": "626-331-6663",
            "fax_number": "626-339-8132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDRE ANDRESIAN,M.D., F.A.C.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2011-02-11",
        "status": "A",
        "authorized_official_last_name": "ANDRESIAN",
        "authorized_official_first_name": "SUSANNE",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "626-331-6663",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A25075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.