Individual
ANASTASIA MARIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2888 LONG BEACH BLVD, SUITE 240, LONG BEACH, CA 90806-1530
(562) 595-7696
(562) 490-3846
Mailing address
2888 LONG BEACH BLVD, SUITE 240, LONG BEACH, CA 90806-1530
(562) 595-7696
(562) 490-3846
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA17941
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G99710
—
CA
01
—
W19727
GROUP ID
CA
Enumeration date
06/08/2006
Last updated
04/19/2011
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