Provider Demographics
NPI:1326896838
Name:SOROTEN, ISAIAH
Entity type:Individual
Prefix:
First Name:ISAIAH
Middle Name:
Last Name:SOROTEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5707 W COG HILL TER
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-1168
Mailing Address - Country:US
Mailing Address - Phone:925-819-0294
Mailing Address - Fax:
Practice Address - Street 1:5707 W COG HILL TER
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-1168
Practice Address - Country:US
Practice Address - Phone:925-819-0294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study