Provider Demographics
NPI:1730525411
Name:JAMES L ANDREWS MD INC
Entity type:Organization
Organization Name:JAMES L ANDREWS MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-629-6188
Mailing Address - Street 1:393 BLOSSOM HILL RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-1652
Mailing Address - Country:US
Mailing Address - Phone:408-629-6188
Mailing Address - Fax:408-578-6635
Practice Address - Street 1:393 BLOSSOM HILL RD
Practice Address - Street 2:SUITE 301
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-1652
Practice Address - Country:US
Practice Address - Phone:408-629-6188
Practice Address - Fax:408-578-6635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-21
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG31942261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G319421OtherMEDICARE PTAN