Provider Demographics
NPI:1013002435
Name:ANDERSON, ALBERT R III (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:R
Last Name:ANDERSON
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:81767 DR CARREON BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-5598
Mailing Address - Country:US
Mailing Address - Phone:760-863-5355
Mailing Address - Fax:760-863-5885
Practice Address - Street 1:552 S PASEO DOROTEA STE 2
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-1437
Practice Address - Country:US
Practice Address - Phone:760-320-6988
Practice Address - Fax:760-320-9796
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2024-03-12
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Provider Licenses
StateLicense IDTaxonomies
CAA56013207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A560133Medicare ID - Type Unspecified
CAG12403Medicare UPIN