Individual
DR. BRADLEY W ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2169 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150-7059
(530) 543-5400
(530) 544-1959
Mailing address
1111 EMERALD BAY RD, SOUTH LAKE TAHOE, CA 96150-6207
(530) 543-5659
(530) 541-8723
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
15032
NV
208800000X
Urology Physician
Primary
C127871
CA
Other
Enumeration date
09/28/2006
Last updated
07/16/2014
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