1942518519 NPI number — DR. SHERRY MILA ANDREWS M.D.

Table of content: DR. SHERRY MILA ANDREWS M.D. (NPI 1942518519)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942518519 NPI number — DR. SHERRY MILA ANDREWS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANDREWS
Provider First Name:
SHERRY
Provider Middle Name:
MILA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MODINO
Provider Other First Name:
SHERRY
Provider Other Middle Name:
MILA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1942518519
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/10/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1600 EUREKA RD
Provider Second Line Business Mailing Address:
MOB 1 BUILDING D - PULMONARY MEDICINE (2ND FLOOR)
Provider Business Mailing Address City Name:
ROSEVILLE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95661-3027
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-784-5685
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1600 EUREKA RD
Provider Second Line Business Practice Location Address:
MOB 1 BUILDING D - PULMONARY MEDICINE (2ND FLOOR)
Provider Business Practice Location Address City Name:
ROSEVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95661-3027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-784-5685
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/17/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  A114009 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RP1001X , with the licence number: A114009 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)