Provider Demographics
NPI:1164560231
Name:SANDMAN, LESTER M (MD)
Entity Type:Individual
Prefix:
First Name:LESTER
Middle Name:M
Last Name:SANDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74710 HIGHWAY 111 STE 102
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-3820
Mailing Address - Country:US
Mailing Address - Phone:206-915-6500
Mailing Address - Fax:833-605-0175
Practice Address - Street 1:74710 HIGHWAY 111 STE 102
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-3820
Practice Address - Country:US
Practice Address - Phone:206-915-6500
Practice Address - Fax:833-605-0175
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000259252084P0800X
CAG643242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
F66514Medicare UPIN