Provider Demographics
NPI:1467484931
Name:SONIA SANDOVAL, INC.
Entity type:Organization
Organization Name:SONIA SANDOVAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDOVAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-247-9070
Mailing Address - Street 1:9400 BRIGHTON WAY
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4712
Mailing Address - Country:US
Mailing Address - Phone:310-247-9070
Mailing Address - Fax:310-247-9008
Practice Address - Street 1:9400 BRIGHTON WAY
Practice Address - Street 2:SUITE 301
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4712
Practice Address - Country:US
Practice Address - Phone:310-247-9070
Practice Address - Fax:310-247-9008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty