Healthcare Provider Details

I. General information

NPI: 1205861036
Provider Name (Legal Business Name): SANDRA KAY SAUNDERS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 05/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1990 N CALIFORNIA BLVD STE. 400
WALNUT CREEK CA
94596-3742
US

IV. Provider business mailing address

P.O. BOX 3371
ASHLAND OR
97520
US

V. Phone/Fax

Practice location:
  • Phone: 925-225-5837
  • Fax:
Mailing address:
  • Phone: 541-488-4198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberG63481
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier00G634810
Identifier TypeMEDICAID
Identifier StateCA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: