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Individual

DR. PAUL A SANDOVAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3702 AUTOMATION WAY STE 103, FORT COLLINS, CO 80525-5738
(970) 224-2985
(970) 223-1118
Mailing address
3702 AUTOMATION WAY STE 103, FORT COLLINS, CO 80525-5738
(970) 224-2985
(970) 223-1118

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
51954
CO
390200000X
Student in an Organized Health Care Education/Training Program
TL3374
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
73135381
CO
01
P01222769
RR MEDICARE
CO
Enumeration date
06/22/2009
Last updated
11/05/2019
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