Provider Demographics
NPI:1770549388
Name:SANDLER, WAYNE C (MD)
Entity type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:C
Last Name:SANDLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10323 SANTA MONICA BLVD.
Mailing Address - Street 2:SUITE #101
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025
Mailing Address - Country:US
Mailing Address - Phone:310-556-0263
Mailing Address - Fax:310-556-0278
Practice Address - Street 1:10323 SANTA MONICA BLVD.
Practice Address - Street 2:SUITE 101
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025
Practice Address - Country:US
Practice Address - Phone:310-556-0263
Practice Address - Fax:310-556-0278
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG448022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A49758Medicare UPIN