DAVID MARCELINO SANDOVAL MD NPI 1003872094

Internal Medicine (Rheumatology) in Kennewick, WA

About DAVID SANDOVAL

David Sandoval is a provider in Kennewick, WA. The NPI number assigned to this provider is 1003872094. The practitioner's primary taxonomy code is Internal Medicine (207RR0500X). The provider is registered as an individual and their NPI record was last updated 2 years ago. David Sandoval is registered with Medicare.

NPI1003872094 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Name DAVID MARCELINO SANDOVAL MD
Provider Location Address6710 W OKANOGAN PLACE KENNEWICK, WA 99336 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address560 GAGE BLVD SUITE 203 RICHLAND, WA 99352 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderMale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?No
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date04-26-2006 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date06-17-2015 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

DAVID MARCELINO SANDOVAL MD
6710 W OKANOGAN PLACE
KENNEWICK, WA
ZIP 99336
Phone: (509) 783-2000
Fax: (509) 783-2008
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Mailing Address

DAVID MARCELINO SANDOVAL MD
560 GAGE BLVD
SUITE 203
RICHLAND, WA
ZIP 99352
Phone: (509) 942-3627
Fax: (509) 942-2268

Primary Taxonomy

Taxonomy Code207RR0500X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationRheumatology
License No.MD00032746
License StateWA
Taxonomy DescriptionAn internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
1003872094MEDICAID (05)WA
8903198MEDICARE PIN (08)WA
0284410OTHER (01)WA
F75447MEDICARE UPIN (02)OR

Map Location


DAVID MARCELINO SANDOVAL MD address is 6710 W OKANOGAN PLACE KENNEWICK, WA 99336

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1104993179 BRENDA DIANE PORCO-SMITH ARNP
Individual
Nurse Practitioner (Family)6710 W OKANOGAN PLACE
KENNEWICK, WA 99336
(509) 783-2000