Susana V Sandoval, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A160706 Issued in CA

Practice address

8627 Atlantic Ave # 1
South Gate, CA 90280-3501

Phone

(888) 499-9303

Fax

(323) 312-2988

NPI assigned

Mar 24, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1265963888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8627 ATLANTIC AVE # 1",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902803501",
            "telephone_number": "888-499-9303",
            "fax_number": "323-312-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8627 ATLANTIC AVE # 1",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902803501",
            "telephone_number": "888-499-9303",
            "fax_number": "323-312-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "SUSANA",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-24",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A160706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis James Sanchez, M.D.
• Jonathan Sanchez
• Kimberly Sanchez
• Brian Andrew Sandoval, MD
• Gerardo Sandoval, OTS
• Santa Maria Women & Children Medical Clinic, Inc
• Benjamin Phillip Sapir, D.D.S.
• Satellite Dialysis of Lynwood LLC
• Shaun Pheng Say, PHARMD
• Gail L Scanland

• Family Medicine Physician in South Gate, CA
• Providers in South Gate, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.

Verify at the official NPI Registry.