MEDICARE: JARON ROSS ANDERSEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	ME106838	FL
2	207X00000X	Orthopaedic Surgery Physician	A97202	CA

General Provider Information

NPI Number	:	1639381759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JARON ROSS ANDERSEN MD

Provider Business Mailing Address
First Line	:	14642 NEWPORT AVE STE 105
Second Line	:
City	:	TUSTIN
State	:	CA
Zip	:	92780-6058
Country	:	US
Telephone Number	:	949-688-0958
Fax Number	:	949-688-0960

Provider Business Practice Location Address
First Line	:	14642 NEWPORT AVE STE 105
Second Line	:
City	:	TUSTIN
State	:	CA
Zip	:	92780-6058
Country	:	US
Telephone Number	:	949-688-0958
Fax Number	:	949-688-0960

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	04/24/2026

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