Provider Demographics
NPI:1912220435
Name:WOREN, SANDOR JAY (DO)
Entity Type:Individual
Prefix:DR
First Name:SANDOR
Middle Name:JAY
Last Name:WOREN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1125 E. BROADWAY
Mailing Address - Street 2:#111
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1513
Mailing Address - Country:US
Mailing Address - Phone:818-613-5357
Mailing Address - Fax:818-549-9926
Practice Address - Street 1:5809 ROSEMEAD BLVD
Practice Address - Street 2:#B
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-1832
Practice Address - Country:US
Practice Address - Phone:818-613-5357
Practice Address - Fax:818-559-6699
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A5016207PE0004X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services