MEDICARE: TERESA SANCHEZ PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA23002	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PA23002	OTHER	CA	LICENSE

General Provider Information

NPI Number	:	1407297518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA SANCHEZ PA

Provider Business Mailing Address
First Line	:	1005 E WASHINGTON BLVD STE A
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90021-3020
Country	:	US
Telephone Number	:	213-745-3636
Fax Number	:	213-745-3626

Provider Business Practice Location Address
First Line	:	2801 S SAN PEDRO ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90011-2023
Country	:	US
Telephone Number	:	323-233-3400
Fax Number	:	323-233-3124

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2013
Last Update Date	:	12/03/2018

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Directions to “ TERESA SANCHEZ PA” Practice Location

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