Provider Demographics
NPI:1770803736
Name:MARTHA SANCHEZ O D INC
Entity type:Organization
Organization Name:MARTHA SANCHEZ O D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:323-888-2020
Mailing Address - Street 1:1818 W BEVERLY BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-3966
Mailing Address - Country:US
Mailing Address - Phone:323-888-2020
Mailing Address - Fax:323-888-1090
Practice Address - Street 1:1818 W BEVERLY BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3966
Practice Address - Country:US
Practice Address - Phone:323-888-2020
Practice Address - Fax:323-888-1090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-01
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9494T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty