Russell N Anderson, D.C.
Individual provider Active NPI Independent Medical Examiner Chiropractor · Tehachapi, CA
NPI 1619175288 · NPPES record last updated Dec 7, 2009
Key facts
- NPI
- 1619175288
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Independent Medical Examiner Chiropractor 111NI0013X
- License
- 20106 (CA)
- Practice address
- 20825 South St
Suite a
Tehachapi, CA 93561-6438 - Phone
- (661) 205-5373
- Fax
- (661) 823-7483
- NPI assigned
- Jul 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| B-866 | NV | MD | Independent Medical Examiner Chiropractor |
| 5095 | OR | MD | Oral and Maxillofacial Surgery (Dentist) |
| 20106 | CA | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Medical Examiner Chiropractor | 111NI0013X | 20106 | CA | Yes |
| Independent Medical Examiner Chiropractor | 111NI0013X | B-866 | NV |
Addresses
Primary practice location
20825 South St
Suite a
Tehachapi, CA 93561-6438
Mailing address
20825 South St
Suite a
Tehachapi, CA 93561-6438
Phone (661) 205-5373
Other providers in Tehachapi, CA
- Damon M Allen
- Malinda Leigh Alsop
- Jack Ray Alvord
- Mari F. Anaya
- Michelle Anderson
- Andrea L Stocker
- Antelope Valley Lung Institute Medical Group
- Mary Anziano
- Charles David Arcaro
- Ciarra B Armstrong
All providers in Tehachapi, CA · Independent Medical Examiner Chiropractor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.