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General NPI Number Information
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NPI Number | 1063156347
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Entity Type | Organization
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Legal Business Name | ALBERT ROBERT ANDERSON III A MEDICAL CORPORATION
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Dates
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Enumeration Date | 04/23/2022
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 1000 E LATHAM AVE STE G
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City | HEMET
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State | CA
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Zip | 92543-4409
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Country | US
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Telephone | 951-391-0580
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Fax | 951-391-0585
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Provider Business Mailing Address
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Address Line | 81719 DR CARREON BLVD STE F
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City | INDIO
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State | CA
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Zip | 92201-5518
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Country | US
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Telephone | 760-462-6880
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Fax | 442-300-2206
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Authorized Official
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Title or Position | OWNER
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Name | ALBERT R ANDERSON III
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Credential | MD
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Telephone | 760-760-6983
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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