Doctor Name: | DAVID RON ANDERSON |
NPI Number: | 1063571651 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | G66924 |
Business Practice Address: | 25825 Vermont Ave Harbor City, CA - 907103518 |
Business Phone Number: | 3103255111 |
Business Fax Number: | |
Mailing Address: | 25825 Vermont Ave, HARBOR CITY |
State: | CA |
Postal Code: | 907103518 |
Phone Number: | 3103255111 |
Fax Number: | |
NPI Enumeration Date: | 12/08/2006 |
NPI Last Update Date: | 05/26/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204D00000X |
License Number: | G66924 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
Taxonomy Specialization: | |
Taxonomy Definition: |