Provider Demographics
NPI:1083647325
Name:LAY, SOPHIE A (MD)
Entity Type:Individual
Prefix:DR
First Name:SOPHIE
Middle Name:A
Last Name:LAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591
Mailing Address - Country:US
Mailing Address - Phone:707-648-7337
Mailing Address - Fax:707-643-6907
Practice Address - Street 1:2001 SPRINGS RD
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591
Practice Address - Country:US
Practice Address - Phone:707-648-7337
Practice Address - Fax:707-643-6907
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAV5033208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
I763422Medicare UPIN