Provider Demographics
NPI:1609271501
Name:SANCHO, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:SANCHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4844 N LAKEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1068
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1902 ROYALTY DR
Practice Address - Street 2:SUITE 170
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3030
Practice Address - Country:US
Practice Address - Phone:909-620-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19649225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist