| Kirk G Andrus Md | |
| 
					4135 Main St Kelseyville CA 95451-8941  | |
| (707) 279-2004 | |
| (707) 279-2832 | 
| Full Name | Kirk G Andrus Md | 
|---|---|
| Speciality | Family Medicine | 
| Location | 4135 Main St, Kelseyville, California | 
| Authorized Official Name and Position | Kirk G Andrus (OWNER) | 
| Authorized Official Contact | 7072792204 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Kirk G Andrus Md 4135 Main St Kelseyville CA 95451-8941 Ph: (707) 279-2204  | Kirk G Andrus Md 4135 Main St Kelseyville CA 95451-8941 Ph: (707) 279-2004  | 
| NPI Number | 1700066529 | 
|---|---|
| Provider Enumeration Date | 11/08/2007 | 
| Last Update Date | 01/05/2009 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1700066529 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | G34543 (California) | Primary | 
Adventist Health Clearlake Hospital Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5290 State St, Kelseyville, CA 95451 Phone: 707-279-8813 Fax: 707-279-2241  |