Provider Demographics
NPI:1407904501
Name:SANGUEZA, JOHN D (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:SANGUEZA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 KNOWLES DR
Mailing Address - Street 2:STE. 220
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1549
Mailing Address - Country:US
Mailing Address - Phone:650-906-8502
Mailing Address - Fax:408-379-2672
Practice Address - Street 1:555 KNOWLES DR
Practice Address - Street 2:STE. 220
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1549
Practice Address - Country:US
Practice Address - Phone:650-906-8502
Practice Address - Fax:408-379-2672
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4498213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU96586Medicare UPIN
CA000E44980Medicare ID - Type Unspecified