Provider Demographics
NPI:1255657177
Name:SANDLIN, HOLLIE ETTA (MD)
Entity Type:Individual
Prefix:MRS
First Name:HOLLIE
Middle Name:ETTA
Last Name:SANDLIN
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 1:401 S BARRINGTON AVE APT 225
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-6420
Mailing Address - Country:US
Mailing Address - Phone:206-795-8145
Mailing Address - Fax:
Practice Address - Street 1:924 WESTWOOD BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-2910
Practice Address - Country:US
Practice Address - Phone:310-794-0585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-16
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA120691207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine