MEDICARE: JARON ROSS ANDERSEN

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	207X00000X	Orthopaedic Surgery Physician	ME106838	FL
2	207X00000X	Orthopaedic Surgery Physician	A97202	CA

General Provider Information

NPI Number	:	1639381759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JARON ROSS ANDERSEN

Provider Business Mailing Address
First Line	:	1513 S GRAND AVE
Second Line	:	STE 208
City	:	LOS ANGELES
State	:	CA
Zip	:	90015-3075
Country	:	US
Telephone Number	:	213-765-8088
Fax Number	:

Provider Business Practice Location Address
First Line	:	1513 S GRAND AVE
Second Line	:	STE 208
City	:	LOS ANGELES
State	:	CA
Zip	:	90015-3075
Country	:	US
Telephone Number	:	213-765-8088
Fax Number	:

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

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	02/03/2022

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Directions to “ JARON ROSS ANDERSEN ” Practice Location

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