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Individual

LUCILLE B. ANDERSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
913 SAN RAMON VALLEY BLVD, SUITE 182, DANVILLE, CA 94526
(925) 263-2499
Mailing address
913 SAN RAMON VALLEY BLVD, SUITE 182, DANVILLE, CA 94526
(925) 263-2499

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
C54414
CA
207X00000X
Orthopaedic Surgery Physician
MD0426365
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1013707600001
PA
Enumeration date
04/14/2006
Last updated
10/21/2022
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