Provider Demographics
NPI:1194883488
Name:SORIANO, JOHN GILBERT (DPT)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:GILBERT
Last Name:SORIANO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-1222
Mailing Address - Country:US
Mailing Address - Phone:415-480-8011
Mailing Address - Fax:415-255-8211
Practice Address - Street 1:20 SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1222
Practice Address - Country:US
Practice Address - Phone:415-480-8011
Practice Address - Fax:415-255-8211
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT26708225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0PT267081Medicare PIN