Anderson, John Dietrich

Anderson, John Dietrich is an individual health care provider with primary practice located at 2104 N Village Dr Ste L , Truckee CA 96161-4312. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Anderson, John Dietrich can be contacted via phone (530) 582-6594.

Contact Information

Primary practice address
2104 N Village Dr Ste L Truckee CA 96161-4312
Phone: (530) 582-6594
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X A143587 California

Profile Details

NPI number 1326365651
LBN Legal business name Anderson, John Dietrich
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2010
Last updated Mar 23rd, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326365651 NPPES
Colorado Other 023864 KAISER COMMERCIAL NUMBER
Colorado MEDICAID 22556346 KAISER COMMERCIAL NUMBER

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