Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 20A6922 | CA |
NPI | 1003860032 |
---|---|
Provider Name | Mr. Luis A Sanchez |
First Address | San Bernardino, CA 92423-0069 |
Second Address | Redlands, CA 92373-5916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 26/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00AX69220 | (05) | CA |
020A69220 | BS OF CA (01) | CA |
G67606 | (02) |