Deandrea a Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G74640 Issued in CA

Legal business name

DEANDREA A MEDICAL CORPORATION

Practice address

1101 N Pacific Ave Ste 104
Glendale, CA 91202-4313

Phone

(818) 552-5000

Fax

(818) 552-2959

NPI assigned

Jul 6, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Richard Anthony Deandrea, MDNPI 1699718551

Title

President

Phone

(818) 552-5000

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard A. Deandrea, M.D., N.D.

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1699718551
  NPD (past) Authorized official

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1821029786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N PACIFIC AVE STE 104",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912024313",
            "telephone_number": "818-552-5000",
            "fax_number": "818-552-2959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N PACIFIC AVE STE 104",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912024313",
            "telephone_number": "818-552-5000",
            "fax_number": "818-552-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEANDREA A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "DEANDREA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-552-5000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G74640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "G74640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• De Palma Medical Group, Inc.
• Nathan De Silva
• Crystal Deagueros
• Daisy Josselyn Deagueros
• Belamey Dean
• Shapan Debnath, MD
• Sheila Debnath, MD
• Brandi Alexandria Dechellis, LVN
• Keyla Decos, LCSW
• Hossein Dehghani, M.D.

• Family Medicine Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.