Individual
DOUGLAS J ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17100 EUCLID, FOUNTAIN VALLEY, CA 92708
(714) 966-7200
Mailing address
PO BOX 20140, FOUNTAIN VALLEY, CA 92728-0140
(562) 809-3572
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A40673
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A406730
—
CA
Enumeration date
06/13/2006
Last updated
04/30/2008
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