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General NPI Number Information
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NPI Number | 1750785598
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Entity Type | Individual
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Provider Name | JOSE SANCHEZ URIBE MS, ATC
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Gender | Male
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Dates
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Enumeration Date | 10/21/2014
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Last Update Date | 10/21/2014
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Provider Practice Location Address
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Address Line | 625 HUMANITIES QUAD INTERCOLLEGIATE ATHLETICS BUILDING
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City | IRVINE
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State | CA
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Zip | 92697-4500
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Country | US
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Telephone | 949-396-4395
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Fax |
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Provider Business Mailing Address
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Address Line | 582 KNOWELL PL
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City | COSTA MESA
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State | CA
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Zip | 92627-2621
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Country | US
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Telephone | 949-310-5999
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 040802002
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License Number State | CA
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