Provider Demographics
NPI:1427279918
Name:THE SONOS GROUP
Entity type:Organization
Organization Name:THE SONOS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-651-3415
Mailing Address - Street 1:177 RIVERSIDE AVE
Mailing Address - Street 2:SUITE F 911
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4032
Mailing Address - Country:US
Mailing Address - Phone:949-651-3415
Mailing Address - Fax:
Practice Address - Street 1:177 RIVERSIDE AVE
Practice Address - Street 2:F911
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4032
Practice Address - Country:US
Practice Address - Phone:949-651-3415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG50085174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty