Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | A24095 | CA |
N | 207RI0011X | Interventional Cardiology | A24095 | CA |
NPI | 1003840596 |
---|---|
Provider Name | Edward Temple Anderson |
First Address | Palo Alto, CA 94301-2747 |
Second Address | E Palo Alto, CA 94303-2250 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 18/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A23816 | (02) | CA |