Provider Demographics
NPI:1225066202
Name:SANCHEZ, RODRIGO (DC)
Entity Type:Individual
Prefix:
First Name:RODRIGO
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42544 10TH ST W
Mailing Address - Street 2:SUITE G
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-7079
Mailing Address - Country:US
Mailing Address - Phone:661-940-7171
Mailing Address - Fax:661-940-9080
Practice Address - Street 1:18520 VIA PRINCESSA
Practice Address - Street 2:SUITE C-2
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91387-8326
Practice Address - Country:US
Practice Address - Phone:661-424-0900
Practice Address - Fax:661-424-0924
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26487111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWDC24687BMedicare ID - Type Unspecified
CAU6463Medicare UPIN