Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | A42586 | CA |
NPI | 1023126562 |
---|---|
Provider Name | Robert Evan Anderson |
First Address | Newport Beach, CA 92663-3522 |
Second Address | Newport Beach, CA 92663-3522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 08/07/2007 |