MEDICARE: ANGELICA SANDOVAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1629435375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELICA SANDOVAL

Provider Business Mailing Address
First Line	:	5900 IROQUOIS RD
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-2460
Country	:	US
Telephone Number	:	714-894-7271
Fax Number	:

Provider Business Practice Location Address
First Line	:	3031 S VERMONT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90007-3033
Country	:	US
Telephone Number	:	323-373-2400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2016
Last Update Date	:	12/08/2025

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Directions to “ ANGELICA SANDOVAL ” Practice Location

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