Provider Demographics
NPI:1992969794
Name:SANDOC, EMILY C (OD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:C
Last Name:SANDOC
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:S
Other - Last Name:LALLANA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5638 MISSION CENTER RD STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4348
Mailing Address - Country:US
Mailing Address - Phone:619-295-2900
Mailing Address - Fax:
Practice Address - Street 1:5638 MISSION CENTER RD STE 103
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4348
Practice Address - Country:US
Practice Address - Phone:619-295-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13535152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist