Provider Demographics
NPI:1770014110
Name:DORIA MEDINA SANCHEZ, JORGE ALEJANDRO (MD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:ALEJANDRO
Last Name:DORIA MEDINA SANCHEZ
Suffix:
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 1:1245 WILSHIRE BLVD STE 514
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-4805
Mailing Address - Country:US
Mailing Address - Phone:213-482-5141
Mailing Address - Fax:213-482-8128
Practice Address - Street 1:1245 WILSHIRE BLVD STE 514
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-4805
Practice Address - Country:US
Practice Address - Phone:213-482-5141
Practice Address - Fax:213-482-8128
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA169360207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine