Maxine M. Anderson, M.D., Inc.

Primary specialty

Trauma Surgery PhysicianTaxonomy code 2086S0127X

License

A68783 Issued in CA

Legal business name

MAXINE M. ANDERSON, M.D., INC.

Practice address

3628 E Imperial Hwy
Suite 401
Lynwood, CA 90262-2643

Phone

(424) 213-4290

Fax

(424) 213-4295

NPI assigned

Apr 2, 2008

Organization subpart

No

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

Authorized official

Name

Maxine AndersonNPI 1851303234

Title

Ceo

Phone

(424) 213-4290

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maxine Anderson, M.D.

  • Surgery Physician
  • Lynwood, CA
  • NPI 1851303234

  Trauma Surgery

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269820800000",
    "number": "1639342330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3628 E IMPERIAL HWY",
            "address_2": "SUITE 401",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622643",
            "telephone_number": "424-213-4290",
            "fax_number": "424-213-4295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3628 E IMPERIAL HWY",
            "address_2": "SUITE 401",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622643",
            "telephone_number": "424-213-4290",
            "fax_number": "424-213-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXINE M. ANDERSON, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2010-03-29",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "MAXINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "424-213-4290"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Trauma Surgery",
            "state": "CA",
            "license": "A68783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Trauma Surgery Physician in Lynwood, CA
• Providers in Lynwood, CA by specialty
• Trauma Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.