Provider Demographics
NPI:1801562400
Name:SANCHEZ, MARTIN RUBEN JR
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:RUBEN
Last Name:SANCHEZ
Suffix:JR
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 1:4243 W ALHAMBRA AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-5804
Mailing Address - Country:US
Mailing Address - Phone:559-724-0226
Mailing Address - Fax:
Practice Address - Street 1:4243 W ALHAMBRA AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-5804
Practice Address - Country:US
Practice Address - Phone:559-724-0226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95226859163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse