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General NPI Number Information
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NPI Number | 1922136555
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Entity Type | Individual
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Provider Name | MAGGIE R SANDOVAL NMW
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Gender | Female
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 635 S WESTLAKE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90057-3508
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Country | US
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Telephone | 213-484-8987
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Fax | 213-484-8605
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Provider Business Mailing Address
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Address Line | 340 W ELM AVE
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City | BURBANK
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State | CA
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Zip | 91506-3318
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Country | US
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Telephone | 213-484-8987
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Fax | 213-484-8605
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | NMW01110
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License Number State | CA
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