Provider Demographics
NPI:1588767651
Name:SONKA-MAAREK, SHERRY ELLEN (MD)
Entity type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:ELLEN
Last Name:SONKA-MAAREK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4245
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-1759
Mailing Address - Country:US
Mailing Address - Phone:310-386-2305
Mailing Address - Fax:310-540-4640
Practice Address - Street 1:1300 W SEVENTH STREET
Practice Address - Street 2:LITTLE COMPANY OF MARY SAN PEDRO HOSPITAL REHABCENTRE
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90732-3505
Practice Address - Country:US
Practice Address - Phone:310-386-2305
Practice Address - Fax:310-540-4640
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG73058208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G730580OtherBLUE SHIELD OF CA
CA00G730580Medicaid
CA00G730580Medicaid
CA00G730580OtherBLUE SHIELD OF CA