Provider Demographics
NPI:1902605769
Name:SANCHEZ, TOMAS MIGUEL
Entity type:Individual
Prefix:
First Name:TOMAS
Middle Name:MIGUEL
Last Name:SANCHEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4394 11TH ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-3405
Mailing Address - Country:US
Mailing Address - Phone:609-947-6730
Mailing Address - Fax:
Practice Address - Street 1:38397 INNOVATION CT STE 103
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2631
Practice Address - Country:US
Practice Address - Phone:951-579-0758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94759225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist