Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 32836 | CA |
NPI | 1003226572 |
---|---|
Provider Name | Dr. Ivan Alexander Sanchez |
First Address | Redondo Beach, CA 90277-4719 |
Second Address | Redondo Beach, CA 90277-2162 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2014 |
Last Update Date | 24/11/2014 |