NPI 1811593577

Ricardo Sandoval

Practitioner Prevention Professional Los Angeles, CA

Practice location

Address: 5917 Converse Ave, Los Angeles, CA 90001-1409
Phone: (323) 423-9030
Mailing address: 5715 S Broadway, Los Angeles, CA 90037-4131

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence A5018449 (CA)

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Registry record

NPI: 1811593577
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Dec 2020
Record last updated: 8 Dec 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.