Provider Demographics
NPI:1588957401
Name:SOUND PEDIATRICS
Entity type:Organization
Organization Name:SOUND PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:QING
Authorized Official - Middle Name:
Authorized Official - Last Name:DONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-992-8668
Mailing Address - Street 1:333 GELLERT BLVD
Mailing Address - Street 2:SUITE 229
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2621
Mailing Address - Country:US
Mailing Address - Phone:650-992-8998
Mailing Address - Fax:650-992-8118
Practice Address - Street 1:333 GELLERT BLVD
Practice Address - Street 2:SUITE 229
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2621
Practice Address - Country:US
Practice Address - Phone:650-992-8998
Practice Address - Fax:650-992-8118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78998261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center