Provider Demographics
NPI:1619443751
Name:SENTINEL HEALTHCARE AZ
Entity Type:Organization
Organization Name:SENTINEL HEALTHCARE AZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:HUMBERTO
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-695-8125
Mailing Address - Street 1:PO BOX 13308
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85216-3308
Mailing Address - Country:US
Mailing Address - Phone:480-335-1865
Mailing Address - Fax:914-663-5152
Practice Address - Street 1:22956 S 221ST PL
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-8162
Practice Address - Country:US
Practice Address - Phone:602-424-7967
Practice Address - Fax:602-900-1055
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SENTINEL HEALTHCARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-16
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty