Sandstrom, Cathy Diane

Sandstrom, Cathy Diane is an individual health care provider with primary practice located at 6148 N Discovery Way Suite 100, Boise ID 83713-0201. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Sandstrom, Cathy Diane can be contacted via phone (208) 322-5437.

Contact Information

Primary practice address
6148 N Discovery Way Suite 100 Boise ID 83713-0201
Phone: (208) 322-5437
Fax: (208) 322-4638
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X M5331 Idaho

Profile Details

NPI number 1215926845
LBN Legal business name Sandstrom, Cathy Diane
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2005
Last updated Nov 7th, 2012 - about 12 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 1215926845 NPPES
Other 000010005930 BLUE SHIELD
Other 01338 BLUE SHIELD
MEDICAID 804257200 BLUE SHIELD

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