Individual
DR. ANDREW SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
162 1ST ST BLDG 1402, PORT HUENEME, CA 93043-4316
(936) 523-0454
(805) 982-2071
Mailing address
162 1ST ST BLDG 1402, PORT HUENEME, CA 93043-4316
(936) 523-0454
(805) 982-2071
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0102203574
VA
Other
Enumeration date
01/19/2012
Last updated
04/23/2015
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