Provider Demographics
NPI:1003068503
Name:SANCHEZ, ADRIAN
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ADRIAN
Other - Middle Name:
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:6114 YORK BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042
Mailing Address - Country:US
Mailing Address - Phone:323-255-6698
Mailing Address - Fax:
Practice Address - Street 1:6114 YORK BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-2592
Practice Address - Country:US
Practice Address - Phone:323-255-6698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA483721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice