Individual
DR. JOHN DAVID ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4469 GREEN VALLEY ROAD, FAIRFIELD, CA 94534-1365
(707) 864-8188
(707) 864-8188
Mailing address
4469 GREEN VALLEY ROAD, FAIRFIELD, CA 94534-1365
(707) 864-8188
(707) 864-8188
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G19714
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G19714
MED BOARD OF CALIFORNIA PHYSICIAN & SURGEON
CA
Enumeration date
02/02/2011
Last updated
02/02/2011
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