Healthcare Provider Details

I. General information

NPI: 1811821069
Provider Name (Legal Business Name): DANIEL THOMAS SANCHEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1336 MAYO ST
RIDGECREST CA
93555-8815
US

IV. Provider business mailing address

1336 MAYO ST
RIDGECREST CA
93555-8815
US

V. Phone/Fax

Practice location:
  • Phone: 800-925-4733
  • Fax:
Mailing address:
  • Phone: 800-925-4733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberTCH210727
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: