Provider Demographics
NPI:1922113638
Name:SANDOR, STEVEN MATTHEW (MB, CHB)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MATTHEW
Last Name:SANDOR
Suffix:
Gender:M
Credentials:MB, CHB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10100 SE SUNNYSIDE RD
Mailing Address - Street 2:KAISER PERMANENTE MT. TALBERT MEDICAL OFFICE
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-8970
Mailing Address - Country:US
Mailing Address - Phone:503-285-9321
Mailing Address - Fax:
Practice Address - Street 1:10100 SE SUNNYSIDE RD
Practice Address - Street 2:KAISER PERMANENTE MT. TALBERT MEDICAL OFFICE
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-8970
Practice Address - Country:US
Practice Address - Phone:503-285-9321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD07825207V00000X
WAMD00014396207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology