Provider Demographics
NPI:1093881062
Name:SONDER, CARL R (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:R
Last Name:SONDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8400 E DIXILETA DR
Mailing Address - Street 2:LOT 175
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85262-2256
Mailing Address - Country:US
Mailing Address - Phone:480-580-5500
Mailing Address - Fax:623-486-3747
Practice Address - Street 1:18301 N 79TH AVE
Practice Address - Street 2:STE C126
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8463
Practice Address - Country:US
Practice Address - Phone:623-486-3346
Practice Address - Fax:623-486-3747
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ262362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0871600OtherBCBS OF AZ
AZB17457Medicare UPIN
AZ67090Medicare ID - Type Unspecified