Organization Active NPI

Jeffrey a Sandler MD, a Professional Corporation

  • Specialist
  • San Diego, CA
National Provider Identifier
1033239256
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G23440 Issued in CA
Legal business name
JEFFREY A SANDLER MD, A PROFESSIONAL CORPORATION
Practice address
4060 4TH Ave Ste 340
San Diego, CA 92103-2121
Phone
(619) 497-6188
Fax
(619) 293-0120
NPI assigned
Mar 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jeffrey Alan Sandler, MDNPI 1740270313
Title
Owner
Phone
(619) 497-6188

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X G23440 CA Primary

Addresses

Primary practice location

4060 4TH Ave Ste 340
San Diego, CA 92103-2121

Mailing address

4060 4TH Ave Ste 340
San Diego, CA 92103-2121
Phone (619) 497-6188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050119001137 CA Part B Supplier - Clinic/Group Practice 6406805159 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

4060 4th Ave
Ste 340
San Diego, CA 92103
Phone (619) 497-6188

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690934400000",
    "number": "1033239256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 4TH AVE STE 340",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032121",
            "telephone_number": "619-497-6188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 4TH AVE STE 340",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032121",
            "telephone_number": "619-497-6188",
            "fax_number": "619-293-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY A SANDLER MD, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A",
        "authorized_official_last_name": "SANDLER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-497-6188",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G23440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.