Andrew Dean Anderson, MD
General Practice in Camp Pendleton, CA. Individual provider (NPI-1).
NPI number1992384804
StatusActive
Last updated in NPPESAug 29, 2022
Details
- NPI
- 1992384804
- Entity type
- Individual (NPI-1)
- Name
- Andrew Dean Anderson
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 7, 2021
- Certification date
- Aug 29, 2022
- Last updated
- Aug 29, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · ORDER AND REFERRING ONLY - GENERAL PRACTICE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | 0101275806 | VA | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
200 Mercy Circle DriveCamp Pendleton, CA 92055
Phone 909-855-0012
Mailing address
Po Box 555191Camp Pendleton, CA 92055-5191
Phone 909-855-0012
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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