Individual
ANDREW BREITHAUPT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 MED PLZ, SUITE 450, LOS ANGELES, CA 90095-0001
(310) 825-6911
Mailing address
200 MED PLZ, SUITE 450, LOS ANGELES, CA 90095-0001
(310) 825-6911
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
A118094
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/25/2010
Last updated
09/17/2019
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