Provider Demographics
NPI:1295144210
Name:SANCHEZ, MARVIN CAMARA (PA-C)
Entity type:Individual
Prefix:MR
First Name:MARVIN
Middle Name:CAMARA
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34800 BOB WILSON DR STE 14
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-1014
Mailing Address - Country:US
Mailing Address - Phone:619-532-8400
Mailing Address - Fax:
Practice Address - Street 1:3402 TARAWA RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92155-5003
Practice Address - Country:US
Practice Address - Phone:619-437-5539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman