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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JACK ANDERSON

Active Sole Proprietor

JACK ANDERSON is a Podiatric Surgery healthcare provider located in VICTORVILLE, California. NPI 1982254603 is currently active in the NPPES registry. Verify at CMS.

Podiatric Surgery · VICTORVILLE, CA

Registration Details

NPI Number
1982254603
Provider Type
Individual
Gender
Male
NPI Issued
Sep 14, 2019 (6.9296214506298 yrs)
Last Updated
Sep 25, 2019
Sole Proprietor
Yes

Practice Information

Address
14810 LA MESA RD
VICTORVILLE, CA, 923928639
Browse CA providers · Browse ZIP 92392
Phone
7609510510
Primary Specialty
Podiatric Surgery
3747A0650X

Other Podiatric Surgery Providers in VICTORVILLE, CA

Name Credential NPI
IRENE FAY LUCIOUS 1215588454
VERDELLE ANDERSON 1861028540
MARISOL CUEVAS 1336857994
DEBRA GRAHAM 1992684534
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.