MEDICARE: DR. DAVID LAN ANDERSON AU.D.,CCC-A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	A-120	NV
2	231HA2400X	Assistive Technology Practitioner Audiologist	A-120	NV
3	231HA2500X	Assistive Technology Supplier Audiologist	A-120	NV
4	235500000X	Speech/Language/Hearing Specialist/Technologist	A-120	NV
5	2355A2700X	Audiology Assistant	A-120	NV
6	237600000X	Audiologist-Hearing Aid Fitter	A-120	NV
7	237700000X	Hearing Instrument Specialist	A-120	NV

General Provider Information

NPI Number	:	1285794248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID LAN ANDERSON AU.D.,CCC-A

Provider Business Mailing Address
First Line	:	3120 S RAINBOW BLVD
Second Line	:	STE 202
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6236
Country	:	US
Telephone Number	:	702-233-4327
Fax Number	:	702-233-8837

Provider Business Practice Location Address
First Line	:	3120 S RAINBOW BLVD STE 201
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6235
Country	:	US
Telephone Number	:	702-233-4327
Fax Number	:	702-233-8837

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	02/11/2009

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Directions to “ DR. DAVID LAN ANDERSON AU.D.,CCC-A” Practice Location

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