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Individual
MR. RENE SANDOVAL
Active
Individual
MR. RENE SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
225400000X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225400000X
EMPLOYER
CA
Enumeration date
01/19/2021
Last updated
01/19/2021
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