PAUL ROGER ANDERSON (NPI# 1184605396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184605396 |
| Entity Type | Individual |
| Full Name | PAUL ROGER ANDERSON |
| Credential | PA |
| Practice Address |
1420 N Tracy Blvd Tracy CA 95376-3451 |
| Mailing Address |
4301 Northstar Way Modesto CA 95356-9262 |
| Practice Telephone | 2093422300 |
| Practice Fax Number | 2095244240 |
| Mailing Telephone | 2093422300 |
| Mailing Fax Number | 2095244240 |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2008-05-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | PA15414 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 0PA154140 | 05 | |
| CA | BLUE SHIELD | 0PA154140 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184188146 | Paul Taylor Anderson | Specialist/Technologist | 11672 Stockmeyer Dr, El Paso, TX 79936-0813 | 2019-01-24 |
| 1184096976 | Paul David Anderson Jr. | Home Health Aide | 118 Morell Dr, Simpsonville, SC 29681-4677 | 2015-10-20 |
| 1083850671 | Paul S Anderson | Counselor | 220 Vinita Rd, Nowata, OK 74048-9443 | 2009-01-02 |
| 1063663540 | Paul D. Anderson | Physical Therapist | 75 W Main Street Ct Ste 100, Alpine, UT 84004-5602 | 2008-10-02 |
| 1528250396 | Paul S Anderson | Anesthesiology | 128 Peachtree Ln Ste B, Advance, NC 27006-6783 | 2007-08-15 |
| 1871783050 | Paul Leroy Anderson Jr. | Dentist | 882 Lancaster Ave, Devon, PA 19333 | 2007-07-25 |
| 1508065939 | Paul Edward Anderson | General Practice | Harboldt Rd, Altamont, TN 37301 | 2007-07-16 |
| 1629113303 | Paul Stanley Anderson | Naturopath | 2150 N. 107th St, Suite 400, Seattle, WA 98133-9009 | 2007-02-21 |
| 1043351380 | Paul Dederick Anderson | Internal Medicine | 11272 Merritt St # F, Castroville, CA 95012-3422 | 2007-02-09 |
| 1659449098 | Paul Daniel Anderson | Dentist | 4778 Banning Ave, White Bear Lake, MN 55110-3264 | 2006-12-02 |
| Street Address |
1420 N TRACY BLVD |
| City | TRACY |
| State | CA |
| Zip Code | 95376-3451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134110554 | Janice Marie Crawford | Emergency Medicine | 1420 N Tracy Blvd, Emergency Dept, Tracy, CA 95376-3451 | 2005-11-03 |
| 1578183398 | Rachele Inouye | Physical Therapist | 1420 N Tracy Blvd, Tracy, CA 95376-3451 | 2020-04-22 |
| 1790305639 | Ashley Chow | Pharmacist | 1420 N Tracy Blvd, Tracy, CA 95376-3451 | 2020-04-21 |
| 1912474768 | Jessica F Hoffman | Nurse Practitioner | 1420 N Tracy Blvd, Tracy, CA 95376-3451 | 2018-10-30 |
| 1528550928 | Ruby Khanal | Nurse Practitioner | 1420 N Tracy Blvd, Tracy, CA 95376-3451 | 2018-05-31 |
| 1639661200 | Sabah Ali | Speech-Language Pathologist | 1420 N Tracy Blvd, Tracy, CA 95376-3451 | 2018-05-30 |
| 1568973329 | Rene Gilberto Steinhauer IIi | Nurse Practitioner | 1420 N Tracy Blvd, Tracy, CA 95376-3451 | 2017-10-19 |
| 1477079606 | Jahid Ahmad Wahabzai | Physician Assistant | 1420 N Tracy Blvd, Tracy, CA 95376-3451 | 2017-08-18 |
| 1093251753 | Victor Segura-perez | Nurse Practitioner | 1420 N Tracy Blvd, S3cvo, Tracy, CA 95376-3451 | 2017-01-18 |
| 1821442864 | Sutter Valley Hospitals | General Acute Care Hospital | 1420 N Tracy Blvd, Tracy, CA 95376-3451 | 2016-04-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932757150 | James Burgess Angel | Technician, Other | 455 W. Eaton Ave., Tracy, CA 95376 | 2019-08-30 |
| 1477079655 | Cassandra Sierra | Specialist/Technologist | 632 W 11th St Ste 119, Tracy, CA 95376 | 2017-08-18 |
| 1922465491 | Jasmeer Kaur Uppal | Registered Nurse | 1411 N. Tracy Bl., Tracy, CA 95376 | 2016-01-28 |
| 1679957773 | Amy Forester | Physical Therapy Assistant | 1752 Schantz Way, Tracy, CA 95376 | 2015-07-17 |
| 1477966265 | Sarah Ojeda | Marriage & Family Therapist | 19 East 6th Street, Tracy, CA 95376 | 2014-06-09 |
| 1356761209 | Lucille Nowakowski | Registered Nurse | 95 West 11 Th St, Tracy, CA 95376 | 2014-04-18 |
| 1821417718 | Ricardo Echon | Nurse Practitioner | 644 W 12th Street, Tracy, CA 95376 | 2014-04-08 |
| 1508105354 | Sutter Central Valley Hospitals | Pharmacy | 1420 N. Tracy Blvd., Tracy, CA 95376 | 2013-02-13 |
| 1790034056 | Amy Powers | Counselor | 902 N Central Ave Ste 308, Tracy, CA 95376 | 2012-09-02 |
| 1982951554 | Gurpreet Singh Dhaliwal Md Inc. | Anesthesiology | 1530 Bessie Ave Ste 104, Tracy, CA 95376 | 2012-08-13 |
| Find all providers in zip 95376 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053735043 | Luke Rond | Emergency Medicine | 763 Quail Run Cir, Tracy, CA 95377 | 2014-02-11 |
| 1417939851 | Enrique Zarate | Emergency Medicine | 130 W 11th St Ste D, Tracy, CA 95376-3935 | 2005-11-18 |
| 1134110554 | Janice Marie Crawford | Emergency Medicine | 1420 N Tracy Blvd, Emergency Dept, Tracy, CA 95376-3451 | 2005-11-03 |
| 1821416157 | Laura Ivette Velez Irizarry | Emergency Medicine | 445 W Eaton Ave, Tracy, CA 95376-3420 | 2014-04-03 |
| 1932468774 | Sean Allen Wilkie | Emergency Medicine | 1420 N Tracy Blvd, Dept of Emergency Medicine, Tracy, CA 95376-3451 | 2012-05-14 |
| 1336423516 | Jennifer Bailey | Emergency Medicine | 1420 N Tracy Blvd, Emergency Dept, Tracy, CA 95376-3451 | 2011-10-05 |
| 1376837021 | Phoebe Lee | Emergency Medicine | 1420 N Tracy Blvd, Tracy, CA 95376-3451 | 2011-05-30 |
| 1780876193 | Eileen Luha Sicangco | Emergency Medicine | 445 W Eaton Ave, Tracy, CA 95376-3420 | 2007-08-10 |
| 1225029440 | Andy K Su | Emergency Medicine | 1420 N Tracy Blvd, Tracy, CA 95376-3451 | 2005-11-04 |
| 1215928437 | Alan Tadao Uyeno | Emergency Medicine | 1420 N Tracy Blvd, Emergency Dept., Tracy, CA 95376-3451 | 2005-11-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.