Provider Demographics
NPI:1285332585
Name:VERDAGUER, ANDREW (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:VERDAGUER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 N 2ND ST UNIT 341
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-4064
Mailing Address - Country:US
Mailing Address - Phone:937-287-1907
Mailing Address - Fax:
Practice Address - Street 1:3239 EL CAMINO REAL STE 220
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-2247
Practice Address - Country:US
Practice Address - Phone:937-287-1907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36577111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor