Provider Demographics
NPI:1073722138
Name:SANDERS, RICHARD DAVID (PA)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:DAVID
Last Name:SANDERS
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Gender:M
Credentials:PA
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Mailing Address - Street 1:1010 W LA VETA AVE
Mailing Address - Street 2:THE CENTER FOR CANCER PREVENTION AND TREATMENT
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4304
Mailing Address - Country:US
Mailing Address - Phone:714-734-6214
Mailing Address - Fax:714-734-6211
Practice Address - Street 1:1010 W LA VETA AVE
Practice Address - Street 2:THE CENTER FOR CANCER PREVENTION AND TREATMENT
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4304
Practice Address - Country:US
Practice Address - Phone:714-734-6214
Practice Address - Fax:714-734-6211
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2009-04-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA11300363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant