Provider Demographics
NPI:1033508700
Name:ANDREW P. ORDON, M.D., A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:ANDREW P. ORDON, M.D., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:FAVALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-660-6030
Mailing Address - Street 1:225 SIMI VILLAGE DR
Mailing Address - Street 2:#940358
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93094-7001
Mailing Address - Country:US
Mailing Address - Phone:800-660-6030
Mailing Address - Fax:310-564-0316
Practice Address - Street 1:225 SIMI VILLAGE DR
Practice Address - Street 2:#940358
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93094-7001
Practice Address - Country:US
Practice Address - Phone:800-660-6030
Practice Address - Fax:310-564-0316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-17
Last Update Date:2015-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty