Provider Demographics
NPI:1881652030
Name:DELGADO-CAMPOS, SANDRA Y (MD)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:Y
Last Name:DELGADO-CAMPOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18522 US HIGHWAY 18
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2321
Mailing Address - Country:US
Mailing Address - Phone:760-242-7777
Mailing Address - Fax:888-847-5757
Practice Address - Street 1:18522 US HIGHWAY 18
Practice Address - Street 2:STE. 208
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2321
Practice Address - Country:US
Practice Address - Phone:760-242-9262
Practice Address - Fax:760-242-9264
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92119207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A921190Medicare ID - Type Unspecified
CAI48660Medicare UPIN