Individual
MIKALA FANUCCHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3075 HEALTH CENTER DR STE 102, SAN DIEGO, CA 92123-2773
(858) 637-7888
Mailing address
4420 CLEVELAND AVE APT 3, SAN DIEGO, CA 92116-3913
(507) 429-2810
Taxonomy
Speciality
Code
Description
License number
State
163WX0200X
Oncology Registered Nurse
Primary
95400066
CA
Other
Enumeration date
08/29/2025
Last updated
08/29/2025
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