Sandoval, Jesse

Sandoval, Jesse is an sole proprietor health care provider with primary practice located at 245 N Binkley St Ste 101 , Soldotna AK 99669-7500. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Phlebology. Allopathic & Osteopathic Physicians / Phlebology is his primary health care specialty. Sandoval, Jesse can be contacted via phone (907) 714-4111.

Contact Information

Primary practice address
245 N Binkley St Ste 101 Soldotna AK 99669-7500
Phone: (907) 714-4111
Fax: (907) 262-5191
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 0124 Idaho
Allopathic & Osteopathic Physicians / Phlebology 202K00000X O124 Idaho

Profile Details

NPI number 1972552271
LBN Legal business name Sandoval, Jesse
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 6th, 2006
Last updated Dec 19th, 2023 - about 2 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 1972552271 NPPES
Idaho Other S4620 BLUE CROSS OF IDAHO
Idaho Other 200489062 BLUE CROSS OF IDAHO
Idaho Other 200489062 BLUE CROSS OF IDAHO
Idaho Other 0004676625 BLUE CROSS OF IDAHO
Idaho Other 200489062 BLUE CROSS OF IDAHO
Idaho MEDICAID 004314700 BLUE CROSS OF IDAHO
Idaho Other 200489062 BLUE CROSS OF IDAHO
Idaho Other 200489062 BLUE CROSS OF IDAHO
Idaho Other 000010145826 BLUE CROSS OF IDAHO
Idaho Other 200489062 BLUE CROSS OF IDAHO
Idaho Other 200489062 BLUE CROSS OF IDAHO
Idaho Other 200489062 BLUE CROSS OF IDAHO

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