Individual
TERESA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1200 S DIAMOND BAR BLVD STE 201, DIAMOND BAR, CA 91765-2298
(909) 860-7600
Mailing address
PO BOX 15807, BEVERLY HILLS, CA 90209-1807
(909) 860-7600
(909) 860-7460
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA11830
CA
Other
Enumeration date
12/07/2011
Last updated
12/07/2011
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