MEDICARE: DR. WILLIAM CARL ANDERSON MD

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	207P00000X	Emergency Medicine Physician	G21954	CA
2	207Q00000X	Family Medicine Physician	G21954	CA

General Provider Information

NPI Number	:	1811093982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM CARL ANDERSON MD

Provider Business Mailing Address
First Line	:	364 OCEAN AVENUE
Second Line	:
City	:	LAGUNA BEACH
State	:	CA
Zip	:	92651-2322
Country	:	US
Telephone Number	:	949-494-3740
Fax Number	:	949-497-9369

Provider Business Practice Location Address
First Line	:	364 OCEAN AVENUE
Second Line	:
City	:	LAGUNA BEACH
State	:	CA
Zip	:	92651-2322
Country	:	US
Telephone Number	:	949-494-3740
Fax Number	:

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

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	09/11/2025

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