Individual
BRENT ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2150 ROOSEVELT AVE, REDWOOD CITY, CA 94061-1304
(650) 369-2071
Mailing address
135 CARMELITA DR, MOUNTAIN VIEW, CA 94040-3255
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
121899
MN
183500000X
Pharmacist
17626
WI
183500000X
Pharmacist
Primary
80231
CA
Other
Enumeration date
08/21/2014
Last updated
04/10/2019
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