Provider Demographics
NPI:1265443246
Name:ANDERSON, RODNEY UDELL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:UDELL
Last Name:ANDERSON
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:574 JUNIPERO SERRA BLVD
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-8442
Mailing Address - Country:US
Mailing Address - Phone:650-327-3217
Mailing Address - Fax:650-849-0319
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-723-3391
Practice Address - Fax:650-724-0084
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG22508208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA41604Medicare UPIN