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FRED L ANDERSON DPM

>> Podiatrist >> Podiatric Medicine & Surgery Service Providers

Registrant NPI Number: 1275600017

Individual Registrant:
 FRED L ANDERSON DPM
Gender: M
Not Sole Proprietor

Location and contact information for practice:
18151 BEAR VALLEY RD  HESPERIA, CA 92345-4907 US
Tel: 760-948-7400  Fax: 760-948-7866

Contact information for business:
18151 BEAR VALLEY RD  HESPERIA, CA 92345-4907 US
Tel: 760-948-7400  Fax: 760-948-7866

Registration Information:
NPI: 1275600017
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N213E00000XPodiatric Medicine & Surgery Service Providers
Podiatrist
CAE2293
Y213ES0103XPodiatric Medicine & Surgery Service Providers
Podiatrist
CAE2293

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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