| Richard J. Andolsen, Md Inc. | |
|
465 March Ave Ste A Healdsburg CA 95448-3371 | |
| (707) 433-3369 | |
| (707) 433-7013 |
| Full Name | Richard J. Andolsen, Md Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 465 March Ave Ste A, Healdsburg, California |
| Authorized Official Name and Position | Richard J Andolsen (OWNER) |
| Authorized Official Contact | 7074333369 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard J. Andolsen, Md Inc. 465 March Ave Ste A Healdsburg CA 95448-3371 Ph: (707) 433-3369 | Richard J. Andolsen, Md Inc. 465 March Ave Ste A Healdsburg CA 95448-3371 Ph: (707) 433-3369 |
| NPI Number | 1932229291 |
|---|---|
| Provider Enumeration Date | 03/30/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1355422296 |
|---|---|
| Medicare Enrollment ID | O20080116000535 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932229291 | NPI | - | NPPES |
| 00G319400 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G31940 (California) | Primary |
| Provider Name | Richard J Andolsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376533638 PECOS PAC ID: 6800977844 Enrollment ID: I20080116000522 |
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