Individual
DR. ANDREW C. BREITERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
27281 LAS RAMBLAS, COAST RADIOLOGY IMAGING & INTERVENTION, INC, STE200, MISSION VIEJO, CA 92691
(949) 212-6526
(949) 420-3149
Mailing address
DEPT LA 21789, PASADENA, CA 91185-1789
(949) 263-8620
(800) 409-7005
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G54442
CA
2085R0202X
Diagnostic Radiology Physician
M001433
GU
2085R0202X
Diagnostic Radiology Physician
ME94664
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G544420
BLUE SHIELD
CA
05
—
1770766479
—
CA
Enumeration date
12/17/2007
Last updated
10/25/2010
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