Provider Demographics
NPI:1477826741
Name:BRUCE J. SAND, M.D., INC.
Entity Type:Organization
Organization Name:BRUCE J. SAND, M.D., INC.
Other - Org Name:GOOD TO GREAT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:SAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-370-7263
Mailing Address - Street 1:2955 E. HILLCREST DR.
Mailing Address - Street 2:#107
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-3177
Mailing Address - Country:US
Mailing Address - Phone:805-358-0549
Mailing Address - Fax:805-370-1097
Practice Address - Street 1:2955 E. HILLCREST DR.
Practice Address - Street 2:#107
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-3177
Practice Address - Country:US
Practice Address - Phone:805-358-0549
Practice Address - Fax:805-370-1097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-17
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC20897207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty