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General NPI Number Information
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NPI Number | 1811994429
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Entity Type | Individual
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Provider Name | ANTHONY E SANDOVAL MD
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Gender | Male
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Dates
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Enumeration Date | 06/29/2005
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 2000 S THOMPSON ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-8759
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Country | US
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Telephone | 928-226-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 13460 N 94TH DR STE J1
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City | PEORIA
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State | AZ
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Zip | 85381-4264
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Country | US
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Telephone | 623-876-8816
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Fax | 623-298-0168
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | CDR.0005272
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 21578
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 21578
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License Number State | AZ
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