Active NPI
Rene Sandoval
- Rehabilitation Practitioner
- Altadena, CA
National Provider Identifier
1386234847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- License
- 225400000X
- Practice address
- 760 Mountain View St
Altadena, CA 91001-4996 - Phone
- (626) 798-6793
- NPI assigned
- Jan 19, 2021
- 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 |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | 225400000X | CA | Primary |
Addresses
Primary practice location
760 Mountain View St
Altadena, CA 91001-4996
Mailing address
867 N Fair Oaks Ave
Pasadena, CA 91103-3050
Phone (747) 283-9570
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 225400000X | Other | CA | EMPLOYER |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 225400000X | CA | MD | Rehabilitation Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611014400000",
"number": "1386234847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "867 N FAIR OAKS AVE",
"city": "PASADENA",
"state": "CA",
"postal_code": "911033050",
"telephone_number": "747-283-9570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "760 MOUNTAIN VIEW ST",
"city": "ALTADENA",
"state": "CA",
"postal_code": "910014996",
"telephone_number": "626-798-6793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOVAL",
"first_name": "RENE",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-19",
"last_updated": "2021-01-19",
"certification_date": "2021-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CA",
"license": "225400000X",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPLOYER",
"identifier": "225400000X",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Altadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.