Jesus Eduardo Sandoval

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

LP054802 Issued in AZ

Practice address

617 N Scottsdale Rd Ste D
Scottsdale, AZ 85257-4207

Phone

(480) 990-3720

NPI assigned

Feb 11, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1821742461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2529 W CACTUS RD APT 3014",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850292588",
            "telephone_number": "623-853-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 N SCOTTSDALE RD STE D",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852574207",
            "telephone_number": "480-990-3720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "JESUS",
        "middle_name": "EDUARDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "AZ",
            "license": "LP054802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE NUMBER",
            "identifier": "D08258128",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "10.135.50.35",
            "affiliation": "N",
            "endpointDescription": "IP address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "617 N Scottsdale Rd Ste D",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852574207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeevan Sandhu, OD
• Puneet Singh Sandhu, D.D.S.
• Tal Eli Sandler, M.D.
• Noel Sandoval Garcia, FNP-C
• Ernest M Sandoval, R.PH.
• Michelle Diane Sandoval
• Sarah Imelda Sandoval, OTR/L, MA
• Kumaresan Sandrasegaran, M.D.
• Michael Lee Sandridge, PA-C
• Kara Anne Sands, M.D.

• Licensed Vocational Nurse in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Licensed Vocational Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.