Provider Demographics
NPI:1215106174
Name:RUTLAND, ANDREW (MD, JD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:RUTLAND
Suffix:
Gender:M
Credentials:MD, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7688 E NORTHFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-2416
Mailing Address - Country:US
Mailing Address - Phone:714-863-7443
Mailing Address - Fax:
Practice Address - Street 1:7688 E NORTHFIELD AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-2416
Practice Address - Country:US
Practice Address - Phone:714-863-7443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG24947207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G2470OtherMEDI-CAL
CA00G2471OtherMEDI-CAL
A42455Medicare UPIN