Provider Demographics
NPI:1366861361
Name:HORNYAK, SANDOR ALEX (NP)
Entity Type:Individual
Prefix:
First Name:SANDOR
Middle Name:ALEX
Last Name:HORNYAK
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 ORO DAM BLVD E
Mailing Address - Street 2:SUITE E
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-6052
Mailing Address - Country:US
Mailing Address - Phone:510-326-8591
Mailing Address - Fax:
Practice Address - Street 1:2450 ORO DAM BLVD E
Practice Address - Street 2:SUITE E
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-6052
Practice Address - Country:US
Practice Address - Phone:510-326-8591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95000627363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily