Basic Information
Provider Information
NPI: 1942579115
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ANDRAE-HAMMOND
FirstName: MARIA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: DEPT 34929
Address2: P.O. BOX 39000
City: SAN FRANCISCO
State: CA
PostalCode: 941390001
CountryCode: US
TelephoneNumber: 9259522828
FaxNumber: 9259522850
Practice Location
Address1: 140 BROOKWOOD RD
Address2: SUITE 201
City: ORINDA
State: CA
PostalCode: 945633042
CountryCode: US
TelephoneNumber: 9252549090
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/17/2011
LastUpdateDate: 03/08/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XA118226CAY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
P0157831001CARAILROAD MEDICAREOTHER


Home