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General NPI Number Information
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NPI Number | 1366313306
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Entity Type | Individual
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Provider Name | KEITH SANCHEZ
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Gender |
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Dates
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Enumeration Date | 09/15/2025
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 440 N BARRANCA AVE # 9225
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City | COVINA
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State | CA
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Zip | 91723-1722
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Country | US
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Telephone | 530-619-5053
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Fax |
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Provider Business Mailing Address
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Address Line | 440 N BARRANCA AVE # 9225
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City | COVINA
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State | CA
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Zip | 91723-1722
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Country | US
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Telephone | 530-619-5053
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083S0010X
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Taxonomy Name | Sports Medicine (Preventive Medicine) Physician
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License Number | 95829
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 95829
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2081N0008X
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Taxonomy Name | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 95829
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License Number State | CA
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