Provider Demographics
NPI:1093753113
Name:SANCHEZ, FREDY FERNANDO (DC, PT)
Entity Type:Individual
Prefix:DR
First Name:FREDY
Middle Name:FERNANDO
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:DC, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6633 NEPTUNE CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95120-4537
Mailing Address - Country:US
Mailing Address - Phone:408-799-9524
Mailing Address - Fax:
Practice Address - Street 1:2516 SAMARITAN DR
Practice Address - Street 2:SUITE J
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4108
Practice Address - Country:US
Practice Address - Phone:408-799-9524
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 29588111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor