Individual
CHARLES KENT ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11234 ANDERSON ST RM 2532, LOMA LINDA, CA 92354-2804
(909) 558-4475
(909) 558-4143
Mailing address
11234 ANDERSON ST RM 2532, LOMA LINDA, CA 92354-2804
(909) 558-4475
(909) 558-4143
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G128352
CA
207L00000X
Anesthesiology Physician
MD14731
OR
207L00000X
Anesthesiology Physician
MD60854517
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
177709
—
OR
Enumeration date
06/08/2006
Last updated
11/17/2025
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