Provider Demographics
NPI:1619539723
Name:SANDRA SANDS, D.O., PH.D., INC.
Entity Type:Organization
Organization Name:SANDRA SANDS, D.O., PH.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:SORAYA
Authorized Official - Last Name:SANDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-616-4096
Mailing Address - Street 1:4225 SPRING LN
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-7089
Mailing Address - Country:US
Mailing Address - Phone:916-616-4096
Mailing Address - Fax:
Practice Address - Street 1:19 UPPER RAGSDALE DR STE 150
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-7837
Practice Address - Country:US
Practice Address - Phone:831-333-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-28
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty