Individual
IAN SANDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
999 SAN BERNARDINO RD, UPLAND, CA 91786-4920
(909) 920-4848
Mailing address
PO BOX 148, CLAREMONT, CA 91711-0148
(909) 985-2112
(909) 985-3411
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A63179
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A631790
—
CA
Enumeration date
06/28/2006
Last updated
07/08/2007
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