Sandstrom, Cathy Diane
Sandstrom, Cathy Diane is an individual health care provider with primary practice located at 6148 N Discovery Way Suite 100, Boise ID 83713-0201. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Sandstrom, Cathy Diane can be contacted via phone (208) 322-5437.Contact Information
Primary practice address
6148 N Discovery Way Suite 100
Boise ID 83713-0201
Phone: (208) 322-5437
Fax: (208) 322-4638
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | M5331 | Idaho |
Profile Details
| NPI number | 1215926845 |
|---|---|
| LBN Legal business name | Sandstrom, Cathy Diane |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 17th, 2005 |
| Last updated | Nov 7th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215926845 | NPPES |
| Other | 000010005930 | BLUE SHIELD | |
| Other | 01338 | BLUE SHIELD | |
| MEDICAID | 804257200 | BLUE SHIELD |
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