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General NPI Number Information
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NPI Number | 1043641152
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Entity Type | Organization
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Legal Business Name | SAND COSMETIC INC
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Dates
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Enumeration Date | 11/29/2013
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Last Update Date | 12/28/2013
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Provider Practice Location Address
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Address Line | 1964 WESTWOOD BLVD SUITE #125
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City | LOS ANGELES
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State | CA
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Zip | 90025-4651
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Country | US
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Telephone | 310-441-2263
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3129
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City | TORRANCE
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State | CA
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Zip | 90510-3129
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Country | US
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Telephone | 310-792-3914
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Fax | 855-898-4055
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. NANCY FAYE SAND
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Credential | M.D.
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Telephone | 310-792-3914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QB0002X
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Taxonomy Name | Obesity Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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