Individual
ANDREW SCOTT MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.T.
Contact information
Practice address
2585 COCHRAN ST, SUITE A, SIMI VALLEY, CA 93065-2602
(805) 584-0001
(805) 527-9135
Mailing address
2585 COCHRAN ST, SUITE A, SIMI VALLEY, CA 93065-2602
(805) 584-0001
(805) 527-9135
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 24883
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PT248830
BLUE SHIELD OF CA
CA
01
—
77057605493065A003
TRICARE
CA
01
—
PT00024883
BLUE CROSS OF CA
CA
Enumeration date
05/30/2006
Last updated
09/17/2007
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