JACK MARTIN ANDERSON M.D. NPI 1609948223

NPI Information

  • NPI: 1609948223
  • Provider Name: JACK MARTIN ANDERSON, M.D.
  • Classification: Pediatrics - 2080N0001X
  • Specialization: Neonatal-Perinatal Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3003 HEALTH CENTER DR
    SAN DIEGO, CA
    ZIP 92123
  • Phone: (858) 939-4185

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NPI Details

Jack Martin Anderson, M.D. is a neonatal-perinatal medicine pediatrics in San Diego, CA. The provider is a pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. Jack Martin Anderson, M.D. NPI is 1609948223. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3003 HEALTH CENTER DR
SAN DIEGO, CA
ZIP 92123-700
Phone: (858) 939-4185

The NPI 1609948223 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/15/2006 and was last updated on 12/11/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsG60266CALIFORNIANo
22080N0001XPediatricsNeonatal-Perinatal MedicineG60266CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100G602660MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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