Individual
IAN CHURCHILL ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3555 ROUND BARN CIR, SANTA ROSA, CA 95403
(707) 528-1050
Mailing address
3555 ROUND BARN CIR, SANTA ROSA, CA 95403-1757
(707) 528-1050
(707) 525-3874
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
A49481
CA
207RH0003X
Hematology & Oncology Physician
Primary
A49481
CA
207RX0202X
Medical Oncology Physician
A49481
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A494810
—
CA
Enumeration date
10/11/2006
Last updated
10/14/2021
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