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General NPI Number Information
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NPI Number | 1477507556
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Entity Type | Organization
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Legal Business Name | SANCHEZ CHIROPRACTIC WELLNESS CENTER PAIN MANAGEMENT
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Dates
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Enumeration Date | 05/21/2006
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Last Update Date | 08/21/2013
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Provider Practice Location Address
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Address Line | 2516 SAMARITAN DR SUITE J
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City | SAN JOSE
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State | CA
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Zip | 95124-4108
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Country | US
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Telephone | 408-356-2061
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Fax | 408-356-2071
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Provider Business Mailing Address
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Address Line | 2516 SAMARITAN DR SUITE J
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City | SAN JOSE
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State | CA
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Zip | 95124-4108
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Country | US
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Telephone | 408-356-2061
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Fax | 408-356-2071
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Authorized Official
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Title or Position | C.E.O
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Name | DR. FREDY FERNANDO SANCHEZ
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Credential | D.C., P.T
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Telephone | 408-356-2061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 2966
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC 29588
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License Number State | CA
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