MEDICARE: SANDRA CALLEROS, A PROFESSIONAL CORP

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
1	1223G0001X	General Practice Dentistry	62902	CA
2	1223G0001X	General Practice Dentistry	35478	CA

General Provider Information

NPI Number	:	1891188371
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANDRA CALLEROS, A PROFESSIONAL CORP

Provider Business Mailing Address
First Line	:	131 W GRAND AVE
Second Line	:	SUITE B
City	:	EL SEGUNDO
State	:	CA
Zip	:	90245-3738
Country	:	US
Telephone Number	:	310-414-9564
Fax Number	:	310-414-9773

Provider Business Practice Location Address
First Line	:	131 W GRAND AVE
Second Line	:	SUITE B
City	:	EL SEGUNDO
State	:	CA
Zip	:	90245-3738
Country	:	US
Telephone Number	:	310-414-9564
Fax Number	:	310-414-9773

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SANDRA CALLEROS
Credential	:	DDS
Telephone Number	:	310-414-9564

Provider Enumeration Date	:	03/09/2015
Last Update Date	:	03/09/2015

Similar Medicare Providers

1316940315 — DR. SANDRA CALLEROS DDS
Practice Location Address:

131 W GRAND AVE , SUITE B
EL SEGUNDO, CA
90245-3738

Practice Phone: 310-414-9564
Practice Fax: 310-414-9773

1437178092 — DR. FRANK CHRISTOPHER RAYMER DDS
Practice Location Address:

131 W GRAND AVE , SUITE B
EL SEGUNDO, CA
90245-3738

Practice Phone: 310-414-9564
Practice Fax:

1548283203 — MARCIA J PALMER O.D.
Practice Location Address:

801 N EL CAMINO REAL , #303
SAN MATEO, CA
94401-3738

Practice Phone: 650-685-6303
Practice Fax:

1821661174 — MS. RUBY CHAIREZ DI
Practice Location Address:

2509 COGSWELL RD
EL MONTE, CA
91732-3738

Practice Phone: 818-844-3376
Practice Fax:

1376496869 — ADAPTHEALTH WEST, LLC
Practice Location Address:

610 S DOUGLAS ST
EL SEGUNDO, CA
90245-4811

Practice Phone: 610-424-4515
Practice Fax:

1407709447 — CIERRA DASHER
Practice Location Address:

100 N PACIFIC COAST HWY
EL SEGUNDO, CA
90245-4359

Practice Phone: 310-856-0800
Practice Fax:

Directions to “SANDRA CALLEROS, A PROFESSIONAL CORP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.