Provider Demographics
NPI:1376862466
Name:SANDRU, MARILENA (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARILENA
Middle Name:
Last Name:SANDRU
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 1:5725 W LAS POSITAS BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-4054
Mailing Address - Country:US
Mailing Address - Phone:925-416-6767
Mailing Address - Fax:925-416-6790
Practice Address - Street 1:5725 W LAS POSITAS BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-4054
Practice Address - Country:US
Practice Address - Phone:925-416-6767
Practice Address - Fax:925-416-6790
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA111760207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine