Provider Demographics
NPI:1427687466
Name:SANDO, KELSI
Entity type:Individual
Prefix:
First Name:KELSI
Middle Name:
Last Name:SANDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 WESTSIDE DR APT 341
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1235
Mailing Address - Country:US
Mailing Address - Phone:714-417-4993
Mailing Address - Fax:
Practice Address - Street 1:7777 WESTSIDE DR APT 341
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1235
Practice Address - Country:US
Practice Address - Phone:714-417-4993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist