Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | PT299745 | CA |
NPI | 1306438809 |
---|---|
Provider Name | Abraham Sanchez |
First Address | Fullerton, CA 92831-1740 |
Second Address | La Habra, CA 90631-6143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2021 |
Last Update Date | 05/02/2021 |