Provider Demographics
NPI:1205859733
Name:SANCHEZ, DENNIS JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:JAMES
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4347 CLUBHOUSE DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-3755
Mailing Address - Country:US
Mailing Address - Phone:562-425-4841
Mailing Address - Fax:
Practice Address - Street 1:3529 FIRESTONE BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-3031
Practice Address - Country:US
Practice Address - Phone:323-566-1700
Practice Address - Fax:323-566-3816
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG48388207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G483881Medicaid
CA00G483880Medicaid
CA00G483881Medicaid
CAG48388AMedicare ID - Type UnspecifiedMEDICARE NUMBER 2ND OFC
CAA51033Medicare UPIN