Graham Douglas Andersen, DC, DACBSP, CCN

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC17373 Issued in CA

Practice address

916 E Imperial Hwy
Brea, CA 92821-5612

Phone

(714) 990-0824

Fax

(714) 990-1917

NPI assigned

Aug 30, 2006

Last updated

Aug 27, 2010By 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 3

Addresses

Other names 1

• G Douglas Andersen Professional name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282867200000",
    "number": "1972613370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 E IMPERIAL HWY",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928215612",
            "telephone_number": "714-990-0824",
            "fax_number": "714-990-1917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 E IMPERIAL HWY",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928215612",
            "telephone_number": "714-990-0824",
            "fax_number": "714-990-1917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "GRAHAM",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "DC, DACBSP, CCN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC17373",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC17373",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "CA",
            "license": "3910",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "G",
            "last_name": "ANDERSEN",
            "middle_name": "DOUGLAS",
            "credential": "DC, DACBSP, CCN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Dominique Alvarez
• Aya Hassan Ali Alwardi, DDS
• Amar Hospice Inc.
• Anaheim Urgent Care, Inc. (UrgentMed-Brea)
• Ancient Wellness Consultant Co.,
• Kathy Arleene Anderson, LMFT
• Lucyna Izabela Ando, SLP-CCC
• Andres K. Martinez, D.D.S., Inc.
• Angel of Love Management and Consulting LLC (Hearts in Home Senior Care Provider)
• Lorrayna Isabel Angel, LCSW

• Chiropractor in Brea, CA
• Providers in Brea, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.