Provider Demographics
NPI:1629044748
Name:SANDERS, PAUL D (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:D
Last Name:SANDERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2190 LYNN RD
Mailing Address - Street 2:STE 220
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-1859
Mailing Address - Country:US
Mailing Address - Phone:805-495-8050
Mailing Address - Fax:805-496-2160
Practice Address - Street 1:227 WEST JANSS RD
Practice Address - Street 2:STE 350
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360
Practice Address - Country:US
Practice Address - Phone:805-495-7439
Practice Address - Fax:805-494-4218
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2016-05-12
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Provider Licenses
StateLicense IDTaxonomies
CAG27075207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G270750Medicaid
CA00G270750Medicaid
G27075Medicare ID - Type Unspecified