Individual
JOB L SANDOVAL
Active
Individual
JOB L SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29158
CT
207R00000X
Internal Medicine Physician
7098
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004674595
AETNA
—
01
—
010007098RL01
CONNECTICUT BLUE CROSS
—
01
—
0400364
UNITED HEALTH
—
01
—
050431424 02891 A001
TRICARE
—
01
—
0R0283
HEALTH NET
—
01
—
110020788
RAILROAD MEDICARE
RI
05
—
1790815157
—
CT
01
—
3066520
CONNECTICUT MEDICAL ASSIS
—
01
—
4095
RI BLUE CHIP
—
01
—
41605
BLUE SHIELD
RI
01
—
41605
FEDERAL BLUE SHIELD
—
01
—
731424
CONNECTICARE
—
05
—
9000416
—
RI
01
—
9258294
CIGNA
—
01
—
D400654480
MEDICARE
CT
01
—
D400737416
MEDICARE
CT
01
—
P02475705
RAILROAD MEDICARE
CT
01
—
P405784
OXFORD
—
Enumeration date
03/06/2007
Last updated
08/23/2021
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