Provider Demographics
NPI:1447097902
Name:OJEDA, ANDREW B
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:B
Last Name:OJEDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7918 RESEDA BLVD APT 306
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-1955
Mailing Address - Country:US
Mailing Address - Phone:818-939-2300
Mailing Address - Fax:
Practice Address - Street 1:7918 RESEDA BLVD APT 306
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-1955
Practice Address - Country:US
Practice Address - Phone:818-939-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist