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General NPI Number Information
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NPI Number | 1275600017
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Entity Type | Individual
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Provider Name | FRED L ANDERSON DPM
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Gender | Male
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 11/03/2017
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Provider Practice Location Address
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Address Line | 18151 BEAR VALLEY RD
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City | HESPERIA
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State | CA
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Zip | 92345-4907
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Country | US
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Telephone | 760-948-7400
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Fax | 760-948-7866
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Provider Business Mailing Address
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Address Line | 18151 BEAR VALLEY RD
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City | HESPERIA
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State | CA
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Zip | 92345-4907
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Country | US
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Telephone | 760-948-7400
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Fax | 760-948-7866
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | E2293
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E2293
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License Number State | CA
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