Provider Demographics
NPI:1922027630
Name:GIRON, ANDRES ENRIQUE (MD)
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:ENRIQUE
Last Name:GIRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 MARIN ST.
Mailing Address - Street 2:SUITE 110
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4102
Mailing Address - Country:US
Mailing Address - Phone:805-496-0440
Mailing Address - Fax:805-496-9808
Practice Address - Street 1:555 MARIN ST
Practice Address - Street 2:SUITE 110
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4236
Practice Address - Country:US
Practice Address - Phone:805-496-0440
Practice Address - Fax:805-496-9808
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42914207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE01664Medicare UPIN
CAA42914Medicare PIN