Provider Demographics
NPI:1982900973
Name:MISSION INFECTIOUS DISEASE & INFUSION CONSULTANTS INC
Entity type:Organization
Organization Name:MISSION INFECTIOUS DISEASE & INFUSION CONSULTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SANDEEP
Authorized Official - Middle Name:ASHU
Authorized Official - Last Name:SONI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-312-5459
Mailing Address - Street 1:PO BOX 1770
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91944-1770
Mailing Address - Country:US
Mailing Address - Phone:619-464-1165
Mailing Address - Fax:619-567-1011
Practice Address - Street 1:15644 POMERADO RD
Practice Address - Street 2:SUITE 202
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2400
Practice Address - Country:US
Practice Address - Phone:858-312-5459
Practice Address - Fax:858-345-3743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-08
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA106937207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty