MEDICARE: DR. MIKAYLA RAE SANCHEZ OD

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	0618001737	VA

General Provider Information

NPI Number	:	1770776254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIKAYLA RAE SANCHEZ OD

Provider Business Mailing Address
First Line	:	2450 CRAVEN ST BLDG 3300
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92136-5599
Country	:	US
Telephone Number	:	619-556-8063
Fax Number	:

Provider Business Practice Location Address
First Line	:	2450 CRAVEN ST BLDG 3300
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92136-7047
Country	:	US
Telephone Number	:	619-556-8063
Fax Number	:

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

Provider Enumeration Date	:	08/20/2007
Last Update Date	:	07/07/2025

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