Healthcare Provider Details

I. General information

NPI: 1639462385
Provider Name (Legal Business Name): JOHN MANUEL SANCHEZ L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2011
Last Update Date: 05/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 E 7TH ST
LONG BEACH CA
90804-4436
US

IV. Provider business mailing address

1910 KNOXVILLE AVE
LONG BEACH CA
90815-3439
US

V. Phone/Fax

Practice location:
  • Phone: 408-510-1438
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number10062
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: