Provider Demographics
NPI:1033802913
Name:SONO CENTER MEDICAL GROUP
Entity Type:Organization
Organization Name:SONO CENTER MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:KALANTAR OHANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:818-419-4321
Mailing Address - Street 1:960 E GREEN ST STE 166
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2421
Mailing Address - Country:US
Mailing Address - Phone:626-381-9430
Mailing Address - Fax:626-628-3617
Practice Address - Street 1:960 E GREEN ST STE 166
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2421
Practice Address - Country:US
Practice Address - Phone:626-381-9430
Practice Address - Fax:626-628-3617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology