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Dr. Gilbert Owen Andersen

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NPI Number Detailed Information

Provider Information:

Name: Dr. Gilbert Owen Andersen
Gender: M
Provider License Number If Given: A29916

NPI Information:

NPI: 1821091836
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 11/29/2016

Provider Business Mailing Address:

Address: PO BOX 2700
Lompoc, CA 93438
Phone Number: 8057361253
Fax Number: 8057365355

Provider Business Practice Location Address:

Address: 136 N 3RD ST
Lompoc, CA 93436
Phone Number: 8057361253
Fax Number: 8057365355

Provider Taxonomy:

Primary: 207R00000X
Secondary (if any):
State: CA

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