Provider Demographics
NPI:1750785598
Name:SANCHEZ URIBE, JOSE (MS, ATC)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:SANCHEZ URIBE
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:582 KNOWELL PL
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-2621
Mailing Address - Country:US
Mailing Address - Phone:949-310-5999
Mailing Address - Fax:
Practice Address - Street 1:625 HUMANITIES QUAD
Practice Address - Street 2:INTERCOLLEGIATE ATHLETICS BUILDING
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92697-4500
Practice Address - Country:US
Practice Address - Phone:949-396-4395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0408020022255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer