Individual
DR. STEPHEN JEFFREY SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AU.D.
Contact information
Practice address
26726 CROWN VALLEY PKWY, SUITE 210, MISSION VIEJO, CA 92691-6364
(949) 364-4361
(949) 364-7124
Mailing address
26726 CROWN VALLEY PKWY, SUITE 210, MISSION VIEJO, CA 92691-6364
(949) 364-4361
(949) 364-7124
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AU1156
CA
237700000X
Hearing Instrument Specialist
HA2517
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AS004Z
INDIVIDUAL PTAN
CA
01
—
AS362Z
INDIVIDUAL PTAN
CA
01
—
AU0011560
MEDI-CAL ID #
CA
01
—
W15940
GROUP PTAN
CA
01
—
W8109
GROUP PTAN
CA
Enumeration date
08/02/2005
Last updated
02/04/2009
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