Provider Demographics
NPI:1265926109
Name:SANCHEZ, MICHAEL OSCAR
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:OSCAR
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10207 N 45TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-1901
Mailing Address - Country:US
Mailing Address - Phone:602-410-7491
Mailing Address - Fax:
Practice Address - Street 1:5010 E SHEA BLVD STE D202
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4570
Practice Address - Country:US
Practice Address - Phone:602-569-4328
Practice Address - Fax:602-569-4378
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health