Provider Demographics
NPI:1457405920
Name:ANDERSON MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:ANDERSON MEDICAL ASSOCIATES
Other - Org Name:NIRMAL S MEHTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIRMAL
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:MEHTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-365-2545
Mailing Address - Street 1:PO BOX 667
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:CA
Mailing Address - Zip Code:96007-0667
Mailing Address - Country:US
Mailing Address - Phone:530-365-2545
Mailing Address - Fax:530-365-7349
Practice Address - Street 1:2830 EAST ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:CA
Practice Address - Zip Code:96007-3408
Practice Address - Country:US
Practice Address - Phone:530-365-2545
Practice Address - Fax:530-365-7349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2009-11-10
Deactivation Date:2008-08-11
Deactivation Code:
Reactivation Date:2009-11-10
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARHM53832HMedicaid
CAGR0092270Medicaid
CAZZZ14573ZMedicare PIN
CA553832Medicare Oscar/Certification
CAGR0092270Medicaid