Anderson, Kerry Scot
Anderson, Kerry Scot is an sole proprietor health care provider with primary practice located at 14335 Pipeline Ave , Chino CA 91710-5642. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Anderson, Kerry Scot can be contacted via phone (909) 628-8860.Contact Information
Primary practice address
14335 Pipeline Ave
Chino CA 91710-5642
Phone: (909) 628-8860
Fax: (909) 628-6120
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT 9775 TPA | California |
Profile Details
| NPI number | 1851404628 |
|---|---|
| LBN Legal business name | Anderson, Kerry Scot |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 16th, 2006 |
| Last updated | Dec 28th, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851404628 | NPPES |
| California | MEDICAID | SD0097750 |
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