Provider Demographics
NPI:1841231263
Name:PAVIA SANCHEZ, ORESTES A (MD)
Entity Type:Individual
Prefix:
First Name:ORESTES
Middle Name:A
Last Name:PAVIA 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 1:8787 HALL RD
Mailing Address - Street 2:
Mailing Address - City:LAMONT
Mailing Address - State:CA
Mailing Address - Zip Code:93241-1953
Mailing Address - Country:US
Mailing Address - Phone:661-845-3731
Mailing Address - Fax:661-845-1157
Practice Address - Street 1:8787 HALL RD
Practice Address - Street 2:
Practice Address - City:LAMONT
Practice Address - State:CA
Practice Address - Zip Code:93241-1953
Practice Address - Country:US
Practice Address - Phone:661-845-3731
Practice Address - Fax:661-845-1157
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA139299207R00000X
PR13243207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRI40712Medicare UPIN
PR2-3294Medicare ID - Type Unspecified