Active NPI
David Marcelino Sandoval, MD
- Rheumatology Physician
- Kennewick, WA
National Provider Identifier
1003872094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- MD00032746
- Practice address
- 6710 W Okanogan Place
Kennewick, WA 99336 - Phone
- (509) 783-2000
- Fax
- (509) 783-2008
- NPI assigned
- Apr 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | MD00032746 | WA | Primary |
Addresses
Primary practice location
6710 W Okanogan Place
Kennewick, WA 99336
Mailing address
560 Gage Blvd
Suite 203
Richland, WA 99352
Phone (509) 942-3627
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003872094 | Medicaid | WA | |
| 0284410 | Other | WA | L&I |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00032746 | WA | MD | Rheumatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434499200000",
"number": "1003872094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "560 GAGE BLVD",
"address_2": "SUITE 203",
"city": "RICHLAND",
"state": "WA",
"postal_code": "99352",
"telephone_number": "509-942-3627",
"fax_number": "509-942-2268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6710 W OKANOGAN PLACE",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "99336",
"telephone_number": "509-783-2000",
"fax_number": "509-783-2008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOVAL",
"first_name": "DAVID",
"middle_name": "MARCELINO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-26",
"last_updated": "2015-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "WA",
"license": "MD00032746",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1003872094",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "0284410",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kennewick, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.