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FRED L ANDERSON DPM
>> Podiatrist >> Podiatric Medicine & Surgery Service ProvidersRegistrant NPI Number: 1275600017
Individual Registrant: FRED L ANDERSON DPM
Gender: M
Not Sole Proprietor
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
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
Tel: 760-948-7400 Fax: 760-948-7866
Registration Information:
NPI: 1275600017
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 213E00000X | Podiatric Medicine & Surgery Service Providers Podiatrist | CA | E2293 |
| Y | 213ES0103X | Podiatric Medicine & Surgery Service Providers Podiatrist | CA | E2293 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
