Provider Demographics
NPI:1639451479
Name:SANDY, DANIEL R (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:R
Last Name:SANDY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 LAKE BLVD E
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-2913
Mailing Address - Country:US
Mailing Address - Phone:530-229-1519
Mailing Address - Fax:530-229-1522
Practice Address - Street 1:346 CYNTHIANN LN
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-8022
Practice Address - Country:US
Practice Address - Phone:530-356-6430
Practice Address - Fax:530-245-1046
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP5106183500000X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist