Provider Demographics
NPI:1558560920
Name:SANCHEZ, VIDAL JACINTO JR (MD)
Entity Type:Individual
Prefix:DR
First Name:VIDAL
Middle Name:JACINTO
Last Name:SANCHEZ
Suffix:JR
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 1:4001 KING AVE
Mailing Address - Street 2:CSP CORCORAN ACH
Mailing Address - City:CORCORAN
Mailing Address - State:CA
Mailing Address - Zip Code:93212
Mailing Address - Country:US
Mailing Address - Phone:559-992-8800
Mailing Address - Fax:559-992-6196
Practice Address - Street 1:4001 KING AVE
Practice Address - Street 2:CSP CORCORAN ACH
Practice Address - City:CORCORAN
Practice Address - State:CA
Practice Address - Zip Code:93212
Practice Address - Country:US
Practice Address - Phone:559-992-8800
Practice Address - Fax:559-992-6196
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35756208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery