Individual provider Active NPI

Eric Martin Sanderson, M.D.

  • Internal Medicine Physician
  • Rancho Mirage, CA
National Provider Identifier
1083620231
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C-41420 Issued in CA
Practice address
39000 Bob Hope Dr
Wright BLDG, Suite 409
Rancho Mirage, CA 92270-3221
Phone
(760) 346-3498
Fax
(760) 779-0478
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C-41420 CA Primary

Addresses

Primary practice location

39000 Bob Hope Dr
Wright BLDG, Suite 409
Rancho Mirage, CA 92270-3221

Mailing address

2380 N Leonard Rd
Palm Springs, CA 92262-2728
Phone (760) 325-6391

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101130000710 CA Practitioner - Internal Medicine 2769678929 Practice locations: Rancho Mirage, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C41420CAMDGeneral Practice Dentistry
C-41420CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083620231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 N LEONARD RD",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922622728",
            "telephone_number": "760-325-6391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "address_2": "WRIGHT BLDG, SUITE 409",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-346-3498",
            "fax_number": "760-779-0478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "ERIC",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C-41420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.