Individual
ANDRE CIPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
801 S CHEVY CHASE DR, 230, GLENDALE, CA 91205-4431
(818) 500-5525
Mailing address
801 S CHEVY CHASE DR, 230, GLENDALE, CA 91205-4431
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A124104
CA
Other
Enumeration date
06/04/2013
Last updated
12/03/2021
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