MEDICARE: RUBY SANCHEZ O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	12384T	CA

General Provider Information

NPI Number	:	1023086006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUBY SANCHEZ O.D.

Provider Business Mailing Address
First Line	:	86 HERMAN COURT
Second Line	:
City	:	WATSONVILLE
State	:	CA
Zip	:	95076
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2490 MISSION STREET
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-2415
Country	:	US
Telephone Number	:	415-550-8778
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	06/27/2012

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