| Sandra Madrid M D Inc | |
|
12462 Washington Blvd Whittier CA 90602-1005 | |
| (562) 693-0725 | |
| (562) 693-2468 |
| Full Name | Sandra Madrid M D Inc |
|---|---|
| Speciality | General Practice |
| Location | 12462 Washington Blvd, Whittier, California |
| Authorized Official Name and Position | Sandra Madrid (PRESIDENT/OWNER) |
| Authorized Official Contact | 5626930725 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandra Madrid M D Inc 12462 Washington Blvd Whittier CA 90602-1005 Ph: (562) 693-0725 | Sandra Madrid M D Inc 12462 Washington Blvd Whittier CA 90602-1005 Ph: (562) 693-0725 |
| NPI Number | 1770594640 |
|---|---|
| Provider Enumeration Date | 08/10/2006 |
| Last Update Date | 02/02/2011 |
| Medicare PECOS PAC ID | 3173550688 |
|---|---|
| Medicare Enrollment ID | O20050726000578 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770594640 | NPI | - | NPPES |
| 00G418900 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | G41890 (California) | Primary |
| Provider Name | Sandra G Madrid |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1427016765 PECOS PAC ID: 6305026022 Enrollment ID: I20110211000457 |
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