Individual
DR. ANDREW W FOGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1775 HARRISON AVE, EUREKA, CA 95501-1338
(707) 445-8080
(707) 445-8088
Mailing address
1775 HARRISON AVE, EUREKA, CA 95501-1338
(707) 445-8080
(707) 445-8088
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC 26719
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0267190
MEDICARE PTAN
CA
05
—
DC0267190
—
CA
Enumeration date
09/23/2005
Last updated
07/19/2017
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