Provider Demographics
NPI:1003944554
Name:MOMAND, SOPHIA SHEREEN (MD)
Entity Type:Individual
Prefix:DR
First Name:SOPHIA
Middle Name:SHEREEN
Last Name:MOMAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1970 S PROSPECT AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-6005
Mailing Address - Country:US
Mailing Address - Phone:310-540-5056
Mailing Address - Fax:310-540-4645
Practice Address - Street 1:1970 S PROSPECT AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-6005
Practice Address - Country:US
Practice Address - Phone:310-540-5056
Practice Address - Fax:310-540-4645
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA048769207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine