Brian Mark Anderson

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Practice address

3855 Health Sciences Dr
La Jolla, CA 92093-1503

Phone

(858) 246-0886

NPI assigned

Apr 16, 2021

Last updated

Apr 16, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1386225803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 WYNDALE ST APT 333",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304167",
            "telephone_number": "828-446-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 HEALTH SCIENCES DR",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920931503",
            "telephone_number": "858-246-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BRIAN",
        "middle_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-16",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tomer Anbar, PH.D., CGP, CTC
• Eneh-Lieh J Ancheta, NP
• Kristoffer Allan Ancho, PMHNP-BC
• Johndel Andaya
• Aimee Jo Anderson
• Cynthia Lea Anderson, CPNP
• Danica Anderson, PA-C
• Hans Johannes Anderson, M.D.
• Jacqueline Martinico Anderson, MD
• Kierstin Nicole Anderson

• Medical Specialty Clinic/Center in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.