MEDICARE: MARTIN RUBEN SANCHEZ JR.

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	163W00000X	Registered Nurse	95226859	CA

General Provider Information

NPI Number	:	1801562400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTIN RUBEN SANCHEZ JR.

Provider Business Mailing Address
First Line	:	4243 W ALHAMBRA AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-5804
Country	:	US
Telephone Number	:	559-724-0226
Fax Number	:

Provider Business Practice Location Address
First Line	:	4243 W ALHAMBRA AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-5804
Country	:	US
Telephone Number	:	559-724-0226
Fax Number	:

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

Provider Enumeration Date	:	08/23/2021
Last Update Date	:	08/23/2021

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