Healthcare Provider Details

I. General information

NPI: 1841103744
Provider Name (Legal Business Name): JORDIN SANCHEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6507 BISSELL ST
HUNTINGTON PARK CA
90255-5502
US

IV. Provider business mailing address

6507 BISSELL ST
HUNTINGTON PARK CA
90255-5502
US

V. Phone/Fax

Practice location:
  • Phone: 323-845-5237
  • Fax:
Mailing address:
  • Phone: 323-845-5237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number46971
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: