Individual
JOHN PATRICK SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
720 SAINT MICHAELS DR, SANTA FE, NM 87505-7600
(505) 438-9402
Mailing address
720 SAINT MICHAELS DR, SANTA FE, NM 87505-7600
(505) 438-9402
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA2002-0014
NM
363AM0700X
Medical Physician Assistant
Primary
PA2002-0014
NM
Other
Enumeration date
03/18/2008
Last updated
03/18/2008
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