Provider Demographics
NPI:1023034873
Name:FORCE-OBROWSKI, SANDRA KAY (MD)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:KAY
Last Name:FORCE-OBROWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 MILLIKEN AVE STE 350
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-6782
Mailing Address - Country:US
Mailing Address - Phone:909-484-9182
Mailing Address - Fax:909-476-0050
Practice Address - Street 1:7777 MILLIKEN AVE STE 350
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-6782
Practice Address - Country:US
Practice Address - Phone:909-484-9182
Practice Address - Fax:909-476-0050
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG43698207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE86264Medicare UPIN