Provider Demographics
NPI:1194236141
Name:ROBERT SANCHEZ CHIROPRACTIC, PC
Entity type:Organization
Organization Name:ROBERT SANCHEZ CHIROPRACTIC, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:505-398-0458
Mailing Address - Street 1:1221 FLAGMAN WAY STE B1
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-1137
Mailing Address - Country:US
Mailing Address - Phone:505-398-0458
Mailing Address - Fax:
Practice Address - Street 1:5755 OBERLIN DR STE 301
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-4717
Practice Address - Country:US
Practice Address - Phone:858-247-2413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-17
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33605261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center