# DON MICHAEL ENDRESS MD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Don Pedro Family Practice
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104145861
- **Authorized official:** MRS. SANDRA MARIE DE LA TORRE (OFFICE MANAGER)
- **Authorized official phone:** (209) 874-2345

## Contact information

- **Practice address:** 3191 EL PRADO RD, SUITE D, LA GRANGE, CA 95329-9761
- **Practice address phone:** (209) 852-2764
- **Practice address fax:** (209) 852-2766
- **Mailing address:** 2416 CANASTA CT, LA GRANGE, CA 95329-9633
- **Mailing address phone:** (209) 852-2765
- **Mailing address fax:** (209) 852-2766

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A53357 | CT | Yes |

## Other

- **Enumeration date:** 05/20/2010
- **Last updated:** 05/20/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00A533570 | — | CA |