Provider Demographics
NPI:1386885382
Name:SOTO, DAVID RODOLFO (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RODOLFO
Last Name:SOTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 21109
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-9109
Mailing Address - Country:US
Mailing Address - Phone:917-405-8859
Mailing Address - Fax:
Practice Address - Street 1:22268 FOOTHILL BLVD STE 3
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-2723
Practice Address - Country:US
Practice Address - Phone:917-405-8859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-20
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT1895622085R0202X, 2085R0204X
CAA1078052085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology