Individual provider · NPI-1

Garth Alan Anderson

Nurse Practitioner, Family · Loma Linda, CA

NPI number1093421877
StatusActive
Last updated in NPPESJan 25, 2023

Details

NPI
1093421877
Entity type
Individual (NPI-1)
Name
Mr. Garth Alan Anderson
Sex
Male
Sole proprietor
No
Enumeration date
Jan 25, 2023
Certification date
Jan 25, 2023
Last updated
Jan 25, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family95023773CAYes

Practice location

11201 Benton St
Loma Linda, CA 92357-1000

Phone 909-825-7084

Mailing address

10098 Cherry Ave
Cherry Valley, CA 92223-4514

Phone 909-557-7958

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