Healthcare Provider Details

I. General information

NPI: 1730391350
Provider Name (Legal Business Name): MINTA M. SANCHEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MINTA M. MATHEW MD

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 05/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 BALFOUR RD STE 229
BRENTWOOD CA
94513-4952
US

IV. Provider business mailing address

1450 TREAT BLVD STE 300
WALNUT CREEK CA
94597-2168
US

V. Phone/Fax

Practice location:
  • Phone: 925-308-8113
  • Fax:
Mailing address:
  • Phone: 925-952-2855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC152272
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: