Provider Demographics
NPI:1538413869
Name:SANCHEZ, GABRIEL G (CST)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:G
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8185 E AVE
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-1509
Mailing Address - Country:US
Mailing Address - Phone:760-885-5658
Mailing Address - Fax:
Practice Address - Street 1:8185 E AVE
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-1509
Practice Address - Country:US
Practice Address - Phone:760-885-5658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114276246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA114276OtherTHE NATIONAL BOARD OF SURGICAL TECHNOLOGY AND SURGICAL ASSISTING