Provider Demographics
NPI:1699745612
Name:SORIANO, ZORAIDA (MD)
Entity type:Individual
Prefix:DR
First Name:ZORAIDA
Middle Name:
Last Name:SORIANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ZORAIDA
Other - Middle Name:
Other - Last Name:REYNOSO-SORIANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5342 DUDLEY BLVD BLDG 98
Mailing Address - Street 2:
Mailing Address - City:MCCLELLAN
Mailing Address - State:CA
Mailing Address - Zip Code:95652-1012
Mailing Address - Country:US
Mailing Address - Phone:916-561-7400
Mailing Address - Fax:916-561-7405
Practice Address - Street 1:5342 DUDLEY BLVD BLDG 98
Practice Address - Street 2:
Practice Address - City:MCCLELLAN
Practice Address - State:CA
Practice Address - Zip Code:95652-1012
Practice Address - Country:US
Practice Address - Phone:916-561-7400
Practice Address - Fax:916-561-7405
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35067685207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35067685OtherMEDICAL LICENSE NO.
OH0992654Medicaid
F93423Medicare UPIN
0773693Medicare ID - Type Unspecified