Provider Demographics
NPI:1629412440
Name:SANCHEZ, MALA MANDYAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MALA
Middle Name:MANDYAM
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MALA
Other - Middle Name:CHAKRAVARTHY
Other - Last Name:MANDYAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:300 PASTEUR DRIVE
Mailing Address - Street 2:LANE 154
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-5133
Mailing Address - Country:US
Mailing Address - Phone:650-723-6661
Mailing Address - Fax:650-498-6205
Practice Address - Street 1:300 PASTEUR DRIVE
Practice Address - Street 2:LANE 154
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-5133
Practice Address - Country:US
Practice Address - Phone:650-723-6661
Practice Address - Fax:650-498-6205
Is Sole Proprietor?:No
Enumeration Date:2013-04-23
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA132320207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine