Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | A44162 | CA |
NPI | 1043382856 |
---|---|
Provider Name | Anna Sandstrom |
First Address | Oxnard, CA 93036-0607 |
Second Address | Oxnard, CA 93036-0607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 05/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A441620 | (05) | CA |
F11403 | (02) |