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General NPI Number Information
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NPI Number | 1578752929
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Entity Type | Organization
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Legal Business Name | RODMAN SANDOVAL, O.D., INC.
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 10/31/2012
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Provider Practice Location Address
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Address Line | 2021 E 4TH ST STE 100
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City | SANTA ANA
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State | CA
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Zip | 92705-3912
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Country | US
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Telephone | 714-547-6819
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Fax | 714-547-6070
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Provider Business Mailing Address
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Address Line | 2021 E 4TH ST STE 100
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City | SANTA ANA
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State | CA
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Zip | 92705-3912
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Country | US
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Telephone | 714-547-6819
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Fax | 714-547-6070
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RODMAN FIGUEROA SANDOVAL
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Credential | O.D.
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Telephone | 714-547-6819
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT7332TOL
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License Number State | CA
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