Provider Demographics
NPI:1437494432
Name:MARIA SANDRA A UMALI MD INC
Entity Type:Organization
Organization Name:MARIA SANDRA A UMALI MD INC
Other - Org Name:UMALIMEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA SANDRA
Authorized Official - Middle Name:ALZONA
Authorized Official - Last Name:UMALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-964-0597
Mailing Address - Street 1:PO BOX 221360
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91322-1360
Mailing Address - Country:US
Mailing Address - Phone:661-964-0597
Mailing Address - Fax:661-964-0598
Practice Address - Street 1:22621 LYONS AVE
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-1702
Practice Address - Country:US
Practice Address - Phone:661-964-0597
Practice Address - Fax:661-964-0598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34940207R00000X, 207RC0000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05D1000027OtherCLIA
CA05D1000027OtherCLIA
CAE01619Medicare UPIN
CAA34940Medicare PIN