Basic Information
Provider Information | |||||||||
NPI: | 1194495994 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SANCHEZ | ||||||||
FirstName: | VICTOR | ||||||||
MiddleName: | ALEXANDER | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | SANCHEZ | ||||||||
OtherFirstName: | ALEX | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: | 5 | ||||||||
Mailing Information | |||||||||
Address1: | 750 N COMMONS DR STE 200 | ||||||||
Address2: |   | ||||||||
City: | AURORA | ||||||||
State: | IL | ||||||||
PostalCode: | 605047940 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6303035380 | ||||||||
FaxNumber: | 6303035385 | ||||||||
Practice Location | |||||||||
Address1: | 3144 EL CAMINO REAL STE 105 | ||||||||
Address2: |   | ||||||||
City: | CARLSBAD | ||||||||
State: | CA | ||||||||
PostalCode: | 920082194 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7607297800 | ||||||||
FaxNumber: | 7607297878 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 09/14/2021 | ||||||||
LastUpdateDate: | 04/28/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 04/28/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | HA8741 | CA | Y |   | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |   |
No ID Information.