Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 247890 | MA |
N | 208600000X | Surgeon | 247890 | MA |
Y | 2086S0127X | Trauma Surgeon | A100789 | CA |
NPI | 1144420951 |
---|---|
Provider Name | Geoffrey Anderson |
First Address | Los Angeles, CA 90033 |
Second Address | Boston, MA 02108-3325 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2007 |
Last Update Date | 31/07/2018 |