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Individual

MR. DUANE GABRIEL ANDERSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3130 ORCHARD HILL RD, BONITA, CA 91902-1411
(479) 461-4103
Mailing address
5620 PLUMAS ST, SAN DIEGO, CA 92139-1513
(619) 254-6812

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F7056292
DRIVER LICENSE
CA
Enumeration date
09/24/2019
Last updated
09/24/2019
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