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NPI Code Detail

MEDICARE: SANDRA A MATHUR DO

MEDICARE: SANDRA A MATHUR DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician20A6905CA

General Provider Information

NPI Number : 1841250974
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA A MATHUR DO
Provider Business Mailing Address
First Line : 1514 VALLEY VISTA DR
Second Line :
City : DIAMOND BAR
State : CA
Zip : 91765-3929
Country : US
Telephone Number : 909-860-1144
Fax Number : 909-860-3526
Provider Business Practice Location Address
First Line : 1514 VALLEY VISTA DR
Second Line :
City : DIAMOND BAR
State : CA
Zip : 91765-3929
Country : US
Telephone Number : 909-860-1144
Fax Number : 909-860-3526
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2006
Last Update Date : 02/08/2022

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Directions to “ SANDRA A MATHUR DO” Practice Location

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