| Robert B. Sanders D.o., A Prof. Corp. | |
|
225 W Madison Ave Ste 2 El Cajon CA 92020-3454 | |
| (619) 334-7542 | |
| (619) 938-2568 |
| Full Name | Robert B. Sanders D.o., A Prof. Corp. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 225 W Madison Ave Ste 2, El Cajon, California |
| Authorized Official Name and Position | Robert B. Sanders (OWNER) |
| Authorized Official Contact | 6199224272 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert B. Sanders D.o., A Prof. Corp. Po Box 516529 Los Angeles CA 90051-0590 Ph: (866) 284-2771 | Robert B. Sanders D.o., A Prof. Corp. 225 W Madison Ave Ste 2 El Cajon CA 92020-3454 Ph: (619) 334-7542 |
| NPI Number | 1962946442 |
|---|---|
| Provider Enumeration Date | 12/18/2016 |
| Last Update Date | 03/06/2023 |
| Certification Date | 03/06/2023 |
| Medicare PECOS PAC ID | 2466718093 |
|---|---|
| Medicare Enrollment ID | O20171129002424 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962946442 | NPI | - | NPPES |
| 20A5544 | Other | CA | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 20A5544 (California) | Primary |
| Provider Name | Robert B Sanders |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144264300 PECOS PAC ID: 5890606529 Enrollment ID: I20060918000431 |
| Provider Name | Deomel M Soriano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164641650 PECOS PAC ID: 1153688205 Enrollment ID: I20171128003574 |
| Provider Name | Mandy Marie Brannen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891205159 PECOS PAC ID: 7810254604 Enrollment ID: I20171204001354 |
| Provider Name | Janet Marie Chudacek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932606118 PECOS PAC ID: 3274898051 Enrollment ID: I20180525001920 |
| Provider Name | Farhana Maswood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023642196 PECOS PAC ID: 6406226836 Enrollment ID: I20221229002523 |
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