Individual
ANDREW MCREYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1533 EUCLID ST, SANTA MONICA, CA 90404-3306
(310) 451-9747
Mailing address
3200 MOTOR AVE, LOS ANGELES, CA 90034-3710
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
390200000X
OTHER
—
Enumeration date
04/19/2018
Last updated
04/19/2018
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