Provider Demographics
NPI:1326264771
Name:SANDLER, DIANE B (OMDLACCST-D)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:B
Last Name:SANDLER
Suffix:
Gender:F
Credentials:OMDLACCST-D
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5061 MARY ELLEN A VE.
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-4644
Mailing Address - Country:US
Mailing Address - Phone:818-982-5518
Mailing Address - Fax:818-985-1888
Practice Address - Street 1:1078 RIVERSIDE DRIVE
Practice Address - Street 2:SUITE C
Practice Address - City:TOLUCA LAKE
Practice Address - State:CA
Practice Address - Zip Code:91602-2372
Practice Address - Country:US
Practice Address - Phone:818-985-8133
Practice Address - Fax:818-985-1888
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC2942171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist