Individual
ANDREW LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
(909) 558-4074
Mailing address
11234 ANDERSON ST, GME OFFICE WESTERLY SUITE 'C', LOMA LINDA, CA 92354-2804
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A141755
CA
Other
Enumeration date
06/02/2014
Last updated
04/03/2018
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