Andrea D. Anderson, MD., Inc.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A90631 Issued in CA

Legal business name

ANDREA D. ANDERSON, MD., INC.

Practice address

2083 Compton Ave Ste 105
Corona, CA 92881-7288

Phone

(951) 268-8112

Fax

(951) 493-1919

NPI assigned

Feb 20, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Andrea Anderson, MDNPI 1649498015

Title

Proprietor/Medical Director

Phone

(951) 268-8120

Specialties & licenses 1

Addresses

Other names 1

• Professional Wound Care Services Doing business as

Tax ID family

Andrea D Anderson MD Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Andrea D. Anderson, MD., Inc.

  • Surgery Physician
  • Corona, CA
  • NPI 1205667623
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrea Anderson, MD

  • Surgery Physician
  • Corona, CA
  • NPI 1649498015
  NPD Authorized official

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

{
    "created_epoch": "1329696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1508139676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6146",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928786146",
            "telephone_number": "951-268-8120",
            "fax_number": "951-493-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2083 COMPTON AVE STE 105",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928817288",
            "telephone_number": "951-268-8112",
            "fax_number": "951-493-1919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5750 Division St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925063259",
            "country_code": "US",
            "telephone_number": "951-268-8113",
            "fax_number": "951-493-1919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ANDREA D. ANDERSON, MD., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-20",
        "last_updated": "2025-09-02",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "PROPRIETOR/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "951-268-8120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "A90631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Wound Care Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Surgery Physician in Corona, CA
• Providers in Corona, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; 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.