Healthcare Provider Details

I. General information

NPI: 1609934652
Provider Name (Legal Business Name): BARRY R SANCHEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 03/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3291 LOMA VISTA RD
VENTURA CA
93003-3099
US

IV. Provider business mailing address

1720 EL CAMINO REAL SUITE 101
BURLINGAME CA
94010-3224
US

V. Phone/Fax

Practice location:
  • Phone: 805-677-5299
  • Fax:
Mailing address:
  • Phone: 650-652-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA74247
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: