Provider Demographics
NPI:1568418531
Name:CORAZON-PANES SANCHEZ,LLC
Entity Type:Organization
Organization Name:CORAZON-PANES SANCHEZ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CORAZON
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-879-0150
Mailing Address - Street 1:2112 BEL AIR RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047-2786
Mailing Address - Country:US
Mailing Address - Phone:410-879-0150
Mailing Address - Fax:
Practice Address - Street 1:2112 BEL AIR RD
Practice Address - Street 2:SUITE 3
Practice Address - City:FALLSTON
Practice Address - State:MD
Practice Address - Zip Code:21047-2786
Practice Address - Country:US
Practice Address - Phone:410-879-0150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKDZ9COOtherCAREFIRST GROUP NUMBER