Provider Demographics
NPI:1952523250
Name:SANCHEZ, MAYRA (MD)
Entity Type:Individual
Prefix:
First Name:MAYRA
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10010 CAMPUS POINT DR # DR305
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1518
Mailing Address - Country:US
Mailing Address - Phone:858-678-6538
Mailing Address - Fax:858-678-6571
Practice Address - Street 1:10010 CAMPUS POINT DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1518
Practice Address - Country:US
Practice Address - Phone:858-678-6538
Practice Address - Fax:858-678-6538
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA117644207RH0002X
KS946569207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine