Healthcare Provider Details

I. General information

NPI: 1568425171
Provider Name (Legal Business Name): JEFFREY R SANDLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16111 PLUMMER ST
NORTH HILLS CA
91343-2036
US

IV. Provider business mailing address

16141 OTSEGO ST
ENCINO CA
91436-1315
US

V. Phone/Fax

Practice location:
  • Phone: 818-891-7711
  • Fax:
Mailing address:
  • Phone: 203-733-0099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number026266
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: