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General NPI Number Information
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NPI Number | 1952706087
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Entity Type | Individual
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Provider Name | DR. ANTONIO DIAZ SANCHEZ
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Gender | Male
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Dates
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Enumeration Date | 10/31/2014
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 176 AUBURN CT STE 6
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-3692
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Country | US
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Telephone | 805-495-4601
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Fax | 805-495-0861
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Provider Business Mailing Address
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Address Line | 7606 S FULTON PARK BLVD
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City | PORTLAND
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State | OR
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Zip | 97219-2926
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Country | US
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Telephone | 805-801-7883
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 63651
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 63651
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License Number State | CA
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