Healthcare Provider Details

I. General information

NPI: 1598793663
Provider Name (Legal Business Name): F. RYAN ANDERSON, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 01/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 SAN RAMON VALLEY BLVD SUITE 214
DANVILLE CA
94526
US

IV. Provider business mailing address

909 SAN RAMON VALLEY BLVD SUITE 214
DANVILLE CA
94526
US

V. Phone/Fax

Practice location:
  • Phone: 925-820-9898
  • Fax: 925-820-6514
Mailing address:
  • Phone: 925-820-9898
  • Fax: 925-820-6514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG21295
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License NumberG21295
License Number StateCA

VIII. Authorized Official

Name: DR. FREDERICK RYAN ANDERSON
Title or Position: MD/OWNER
Credential: MD
Phone: 925-820-9898