Active NPI
John David Anderson, M.D.
- Urology Physician
- Fairfield, CA
National Provider Identifier
1235435637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- G19714
- Practice address
- 4469 Green Valley Road
Fairfield, CA 94534-1365 - Phone
- (707) 864-8188
- Fax
- (707) 864-8188
- NPI assigned
- Feb 2, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | G19714 | CA | Primary |
Addresses
Primary practice location
4469 Green Valley Road
Fairfield, CA 94534-1365
Mailing address
4469 Green Valley Road
Fairfield, CA 94534-1365
Phone (707) 864-8188
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G19714 | Other | CA | MED BOARD OF CALIFORNIA PHYSICIAN & SURGEON |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G19714 | CA | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787529600000",
"number": "1235435637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4469 GREEN VALLEY ROAD",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945341365",
"telephone_number": "707-864-8188",
"fax_number": "707-864-8188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4469 GREEN VALLEY ROAD",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945341365",
"telephone_number": "707-864-8188",
"fax_number": "707-864-8188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JOHN",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-02-02",
"last_updated": "2026-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "CA",
"license": "G19714",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MED BOARD OF CALIFORNIA PHYSICIAN & SURGEON",
"identifier": "G19714",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.