Sandy, Gisella Laverne

Sandy, Gisella Laverne is an sole proprietor health care provider with primary practice located at 26520 Cactus Ave , Moreno Valley CA 92555-3927. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care, Allopathic & Osteopathic Physicians / Trauma Surgery. Allopathic & Osteopathic Physicians / Surgery is her primary health care specialty. Sandy, Gisella Laverne can be contacted via phone (951) 486-4175.

Contact Information

Primary practice address
26520 Cactus Ave Moreno Valley CA 92555-3927
Phone: (951) 486-4175
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X DR-50308 Colorado
Allopathic & Osteopathic Physicians / Surgery 208600000X M-1845 Guam
Allopathic & Osteopathic Physicians / Surgical Critical Care 2086S0102X A70697 California
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X A70697 California
Allopathic & Osteopathic Physicians / Surgery 208600000X A70697 California

Profile Details

NPI number 1659310860
LBN Legal business name Sandy, Gisella Laverne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 5th, 2006
Last updated Dec 1st, 2021 - about 3 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 1659310860 NPPES
California MEDICAID 00A706970
California MEDICAID 58021736
California Other 00A706970

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