Provider Demographics
NPI:1578434379
Name:SANDEL, MAC LEONARD M
Entity type:Individual
Prefix:
First Name:MAC LEONARD
Middle Name:M
Last Name:SANDEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8487 CEDARVIEW CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-2175
Mailing Address - Country:US
Mailing Address - Phone:909-839-3946
Mailing Address - Fax:
Practice Address - Street 1:8487 CEDARVIEW CT
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-2175
Practice Address - Country:US
Practice Address - Phone:909-839-3946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1342759343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)