Basic Information
| Provider Information | |||||||||
| NPI: | 1407080799 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARLAND | ||||||||
| FirstName: | ANDREA | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5821 JAMESON CT | ||||||||
| Address2: | |||||||||
| City: | CARMICHAEL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956080820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164860411 | ||||||||
| FaxNumber: | 9164860946 | ||||||||
| Practice Location | |||||||||
| Address1: | 5821 JAMESON CT | ||||||||
| Address2: | |||||||||
| City: | CARMICHAEL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956080820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164860411 | ||||||||
| FaxNumber: | 9164868112 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2009 | ||||||||
| LastUpdateDate: | 12/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | A115655 | CA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | A115655 | 01 | AR | MEDICAL STATE LICENSE | OTHER |