Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 20A9520 | CA |
N | 207Q00000X | Family Doctor | 20A9520 | CA |
NPI | 1275718421 |
---|---|
Provider Name | Dr. Jesus Sanchez JR. |
First Address | Pomona, CA 91766-1854 |
Second Address | Pomona, CA 91776-2020 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2008 |
Last Update Date | 11/05/2010 |