Individual
DR. JESSE SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
245 N BINKLEY ST STE 101, SOLDOTNA, AK 99669-7500
(907) 714-4111
(907) 262-5191
Mailing address
PO BOX 7130, BOISE, ID 83707-1130
(208) 333-1472
(208) 333-7757
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
O124
ID
207R00000X
Internal Medicine Physician
0124
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010145826
REGENCE BLUE SHEILD
ID
01
—
0004676625
AETNA
ID
05
—
004314700
—
ID
01
—
200489062
PRIMARY HEALTH NETWORK
ID
01
—
S4620
BLUE CROSS OF IDAHO
ID
Enumeration date
05/06/2006
Last updated
12/19/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us