Provider Demographics
NPI:1265984223
Name:SANDRA BENDER M.D., A PROFESSIONAL CORP
Entity type:Organization
Organization Name:SANDRA BENDER M.D., A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BENDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-769-6581
Mailing Address - Street 1:77824 WILDCAT DR
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-1134
Mailing Address - Country:US
Mailing Address - Phone:708-769-6581
Mailing Address - Fax:708-874-8284
Practice Address - Street 1:77824 WILDCAT DR
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-1134
Practice Address - Country:US
Practice Address - Phone:708-769-6581
Practice Address - Fax:708-874-8284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No207PS0010XAllopathic & Osteopathic PhysiciansEmergency MedicineSports MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty