D. Gordon Anderson, MD., Inc.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

A020223 Issued in CA

Legal business name

D. GORDON ANDERSON, MD., INC.

Practice address

1130 Coffee Rd Ste 5B
Modesto, CA 95355-4228

Phone

(209) 529-2710

Fax

(209) 529-5765

NPI assigned

Apr 22, 2010

Last updated

Apr 22, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. D. Gordon Anderson, M.D.

Title

President

Phone

(209) 529-2710

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1271894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271894400000",
    "number": "1881911477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 COFFEE RD STE 5B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554228",
            "telephone_number": "209-529-2710",
            "fax_number": "209-529-5765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 COFFEE RD STE 5B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554228",
            "telephone_number": "209-529-2710",
            "fax_number": "209-529-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D. GORDON ANDERSON, MD., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-22",
        "last_updated": "2010-04-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "D.",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-529-2710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A020223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic Surgery Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2010; 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.