Individual provider Active NPI

Jose Lucio Sanchez Rodriguez

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1902603921
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1731 E 120TH St
Los Angeles, CA 90059-3051
Phone
(650) 451-8327
NPI assigned
Feb 27, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1731 E 120TH St
Los Angeles, CA 90059-3051

Mailing address

100 Sylvan Ave Apt 5
San Bruno, CA 94066-4337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251119004300 CA Order and Referring Only - Physician Assistant 8325530132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1740614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1902603921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SYLVAN AVE APT 5",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940664337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 E 120TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593051",
            "telephone_number": "650-451-8327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ RODRIGUEZ",
        "first_name": "JOSE",
        "middle_name": "LUCIO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-27",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.