Active NPI
Guillermo Sandoval, MD
- Pediatrics Physician
- Madera, CA
National Provider Identifier
1063552966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G62609
- Practice address
- 344 E 6TH St
Madera, CA 93638-3631 - Phone
- (559) 664-4000
- Fax
- (559) 675-5661
- NPI assigned
- Feb 8, 2007
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G62609 | CA | Primary |
Addresses
Primary practice location
344 E 6TH St
Madera, CA 93638-3631
Mailing address
344 E 6TH St
Madera, CA 93638-3631
Phone (559) 664-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G62609 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Camarena Health | Pediatrics | Current | Accepting new patients |
| Camarena Health | Current | Accepting new patients | |
| Camarena Health | Current | Accepting new patients | |
| Emergency Medicine Physician Partners of Madera County, Inc | Past | Accepting new patients | |
| Fresno Community Hospital and Medical Center | Past | Accepting new patients | |
| Valley Children'S Hospital | Past | Accepting new patients |
Locations
124 S A St
Madera, CA 93638
Phone (559) 664-4042
344 E 6th St
Madera, CA 93638
Phone (559) 664-4158
441 E Yosemite Ave
Madera, CA 93638
49169 Road 426
Oakhurst, CA 93644
Phone (559) 642-6724
Interoperability endpoints
- guillermo.sandoval.1@25900.direct.athenahealth.com
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Los Banos, CA
- NPI 1114757754
-
- Federally Qualified Health Center (FQHC)
- Madera, CA
- NPI 1124533492
-
- Emergency Medicine Physician
- Madera, CA
- NPI 1467753418
-
- General Acute Care Hospital
- Fresno, CA
- NPI 1104906569
-
- Children's Hospital
- Madera, CA
- NPI 1952312043
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378684800000",
"number": "1063552966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "344 E 6TH ST",
"city": "MADERA",
"state": "CA",
"postal_code": "936383631",
"telephone_number": "559-664-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "344 E 6TH ST",
"city": "MADERA",
"state": "CA",
"postal_code": "936383631",
"telephone_number": "559-664-4000",
"fax_number": "559-675-5661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOVAL",
"first_name": "GUILLERMO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-08",
"last_updated": "2013-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G62609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Madera, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.