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General NPI Number Information
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NPI Number | 1679559421
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Entity Type | Individual
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Provider Name | WAYNE E ANDERSON DO
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Gender | Male
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 11/07/2013
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Provider Practice Location Address
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Address Line | 45 CASTRO ST SUITE 225
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-1010
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Country | US
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Telephone | 415-558-8584
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Fax | 415-513-4521
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Provider Business Mailing Address
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Address Line | 45 CASTRO ST SUITE 225
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-1010
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Country | US
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Telephone | 415-558-8584
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Fax | 415-513-4521
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 20A6596
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) Physician
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License Number | 20A6596
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License Number State | CA
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