Provider Demographics
NPI:1063598001
Name:MURRAY, SANDRA JEAN (MD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:JEAN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 CITY DRIVE SOUTH
Mailing Address - Street 2:UCI MEDICAL CENTER, BLDG 56, SUITE 600
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868
Mailing Address - Country:US
Mailing Address - Phone:714-456-6933
Mailing Address - Fax:714-456-7658
Practice Address - Street 1:101 CITY DRIVE
Practice Address - Street 2:UCI MEDICAL CENTER, BLDG 56, SUITE 600
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868
Practice Address - Country:US
Practice Address - Phone:714-456-6933
Practice Address - Fax:714-456-7658
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA069658208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH69658Medicare ID - Type Unspecified