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Contact Information

DEREK SANDOVAL
1100 CENTRAL AVE SE
ALBUQUERQUE, NM87106-4934
 Phone: 505-724-6125
 Fax: 505-724-6125
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acute Care

363LA2100X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for DEREK SANDOVAL · (Male)

NPI # 1740745249
Status Active
Credentials
Entity Individual
Enumeration date 02/08/2019
Last updated 02/08/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • NM License # 54702
Hospital affiliation(s)
  • ALTA VISTA REGIONAL HOSPITAL - (Acute Care)
    104 LEGION DRIVE
    LAS VEGAS, NM 87701
  • LOVELACE WOMEN'S HOSPITAL - (Acute Care)
    4701 MONTGOMERY BOULEVARD NE
    ALBUQUERQUE, NM 87109
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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