Provider Demographics
NPI:1801872221
Name:SANSCHAGRIN, ANDRE R (MD)
Entity type:Individual
Prefix:
First Name:ANDRE
Middle Name:R
Last Name:SANSCHAGRIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:501 N EL CAMINO REAL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1335
Mailing Address - Country:US
Mailing Address - Phone:760-436-0078
Mailing Address - Fax:760-436-9932
Practice Address - Street 1:501 N EL CAMINO REAL
Practice Address - Street 2:SUITE 100
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1335
Practice Address - Country:US
Practice Address - Phone:760-436-0078
Practice Address - Fax:760-436-9932
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG51748207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG51748Medicare ID - Type Unspecified
CAE83328Medicare UPIN