Provider Demographics
NPI:1003057985
Name:SORIANO, AQUILINO MICHAEL (LAC)
Entity Type:Individual
Prefix:
First Name:AQUILINO
Middle Name:MICHAEL
Last Name:SORIANO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 H ST
Mailing Address - Street 2:STE 202
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-5547
Mailing Address - Country:US
Mailing Address - Phone:619-426-4546
Mailing Address - Fax:619-426-0527
Practice Address - Street 1:374 H ST
Practice Address - Street 2:STE 202
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-5547
Practice Address - Country:US
Practice Address - Phone:619-426-4546
Practice Address - Fax:619-426-0527
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5724171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist