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General NPI Number Information
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NPI Number | 1316354830
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Entity Type | Organization
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Legal Business Name | DONALD S STAAB JR, FNP & JOSE R SANCHEZ, MD
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Dates
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Enumeration Date | 07/16/2014
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Last Update Date | 07/16/2014
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Provider Practice Location Address
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Address Line | 3625 MISSION AVE STE D
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City | CARMICHAEL
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State | CA
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Zip | 95608-2954
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Country | US
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Telephone | 916-486-1906
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Fax | 916-486-1206
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Provider Business Mailing Address
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Address Line | 3625 MISSION AVE STE D
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City | CARMICHAEL
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State | CA
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Zip | 95608-2954
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Country | US
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Telephone | 916-486-1906
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Fax | 916-486-1206
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | RICHARD G SLECHTA JR.
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Credential |
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Telephone | 916-601-4513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G61393
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License Number State | CA
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