Individual provider · NPI-1

Dr. Wayne R. Anderson, M.D.

Family Medicine · La Mesa, CA

NPI number1316988587
StatusActive
Last updated in NPPESJun 24, 2009

Details

NPI
1316988587
Entity type
Individual (NPI-1)
Name
Dr. Wayne R. Anderson
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Jun 9, 2006
Last updated
Jun 24, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineG42641CAYes

Practice location

10862 Calle Verde
La Mesa, CA 91941-7338

Phone 619-670-5400

Mailing address

File# 54433
Los Angeles, CA 90074-0001

Phone 858-784-5767 · Fax 858-784-5933

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