Provider Demographics
NPI:1689807075
Name:SANCHEZ, TERESA D (OD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:D
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:11301 WILSHIRE BLVD
Mailing Address - Street 2:OPTOMETRY CLINIC (123) BLDG.304 ROOM 2-111
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90073-1003
Mailing Address - Country:US
Mailing Address - Phone:310-478-3711
Mailing Address - Fax:
Practice Address - Street 1:11301 WILSHIRE BLVD
Practice Address - Street 2:OPTOMETRY CLINIC (123) BLDG.304 RM 2-111
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90073-1003
Practice Address - Country:US
Practice Address - Phone:310-478-3711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA13819152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist