Provider Demographics
NPI:1336282318
Name:SANCHEZ, MARTHA (OD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 W BEVERLY BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-3966
Mailing Address - Country:US
Mailing Address - Phone:323-888-2020
Mailing Address - Fax:323-888-1090
Practice Address - Street 1:1818 W BEVERLY BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3966
Practice Address - Country:US
Practice Address - Phone:323-888-2020
Practice Address - Fax:323-888-1090
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9494T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU18329Medicare UPIN