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Individual

DR. ANDREW WHALEN X

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
99 MONTECILLO RD, SAN RAFAEL, CA 94903-3308
(415) 444-2000
Mailing address
99 MONTECILLO RD, SAN RAFAEL, CA 94903-3308
(415) 444-2000

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
36024
CA
208100000X
Physical Medicine & Rehabilitation Physician
36034
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT36024
PT LICENSE
CA
Enumeration date
06/11/2012
Last updated
02/11/2022
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