Healthcare Provider Details

I. General information

NPI: 1487691192
Provider Name (Legal Business Name): FRANK L ANDERSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 05/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 MARK WEST SPRINGS RD FL 2
SANTA ROSA CA
95403
US

IV. Provider business mailing address

2350 W EL CAMINO REAL FL 2
MOUNTAIN VIEW CA
94040-6203
US

V. Phone/Fax

Practice location:
  • Phone: 707-541-7900
  • Fax: 707-541-5411
Mailing address:
  • Phone: 707-541-7900
  • Fax: 707-573-5411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG54882
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberG54882
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: