Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Jack Booker Anderson II

Individual provider Non-emergency Medical Transport (VAN) · NPI 1215507983

Mr. Jack Booker Anderson II is a Non-emergency Medical Transport (VAN) in Gardena, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2021

Practice location Address checks out

879 W 190th St Ste 400
Gardena, CA 90248-4223
Phone: (310) 887-6382
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Non-emergency Medical Transport (VAN) (primary) Taxonomy 343900000X (CA)

Record details

NPI number1215507983
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 25, 2021
Last updated in NPPESFebruary 7, 2023
Certification dateFebruary 7, 2023

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