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General NPI Number Information
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NPI Number | 1003830258
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Entity Type | Individual
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Provider Name | SANDRA NIETO MD
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Gender | Female
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 09/05/2022
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Provider Practice Location Address
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Address Line | 433 N 4TH ST STE 211
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City | MONTEBELLO
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State | CA
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Zip | 90640-4309
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Country | US
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Telephone | 323-786-8333
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Fax | 323-967-6067
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Provider Business Mailing Address
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Address Line | 8531 VIA SIERRA RAMAL AVE
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City | WHITTIER
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State | CA
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Zip | 90605-1246
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Country | US
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Telephone | 323-786-8833
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Fax | 323-967-6067
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A84185
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License Number State | CA
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