Sandoval, Brian R

Sandoval, Brian R is an sole proprietor health care provider with primary practice located at 400 W 16Th St , Pueblo CO 81003-2745. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Sandoval, Brian R can be contacted via phone (719) 584-4420.

Contact Information

Primary practice address
400 W 16Th St Pueblo CO 81003-2745
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 35181 Colorado

Profile Details

NPI number 1467457028
LBN Legal business name Sandoval, Brian R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 20th, 2005
Last updated Nov 6th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467457028 NPPES
Colorado MEDICAID 01351816

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