Active NPI
Lester M Sandman, MD
- Psychiatry Physician
- Palm Desert, CA
National Provider Identifier
1164560231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G64324
- Practice address
- 74710 Highway 111 Ste 102
Palm Desert, CA 92260-3820 - Phone
- (206) 915-6500
- Fax
- (833) 605-0175
- NPI assigned
- Feb 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD00025925 | WA | |
| Psychiatry Physician | 2084P0800X | G64324 | CA | Primary |
Addresses
Primary practice location
74710 Highway 111 Ste 102
Palm Desert, CA 92260-3820
Mailing address
74710 Highway 111 Ste 102
Palm Desert, CA 92260-3820
Phone (206) 915-6500
Other practice location 1
26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 486-4000
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 |
|---|---|---|---|
| G64324 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Evergreen Clinic | Psychiatry | Current | Accepting new patients |
Locations
10126 NE 132nd St
Kirkland, WA 98034
Phone (425) 821-1810
Interoperability endpoints
- lsandman193534@direct.llu.edu
Organizations & group practices 1
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.
-
- Psychiatry Physician
- Kirkland, WA
- NPI 1447314539
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629763200000",
"number": "1164560231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74710 HIGHWAY 111 STE 102",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922603820",
"telephone_number": "206-915-6500",
"fax_number": "833-605-0175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74710 HIGHWAY 111 STE 102",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922603820",
"telephone_number": "206-915-6500",
"fax_number": "833-605-0175"
}
],
"practiceLocations": [
{
"address_1": "26520 Cactus Ave",
"address_purpose": "LOCATION",
"city": "Moreno Valley",
"state": "CA",
"postal_code": "925553927",
"country_code": "US",
"telephone_number": "951-486-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SANDMAN",
"first_name": "LESTER",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-02",
"last_updated": "2021-08-24",
"certification_date": "2021-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WA",
"license": "MD00025925",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G64324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Palm Desert, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.