# SANDRA MADRID M D INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770594640
- **Authorized official:** SANDRA MADRID M.D. (PRESIDENT/OWNER)
- **Authorized official phone:** (562) 693-0725

## Contact information

- **Practice address:** 12462 WASHINGTON BLVD, WHITTIER, CA 90602-1005
- **Practice address phone:** (562) 693-0725
- **Practice address fax:** (562) 693-2468
- **Mailing address:** 12462 WASHINGTON BLVD, WHITTIER, CA 90602-1005
- **Mailing address phone:** (562) 693-0725
- **Mailing address fax:** (562) 693-2468

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | G41890 | CA | Yes |

## Other

- **Enumeration date:** 08/10/2006
- **Last updated:** 02/02/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00G418900 | — | CA |