Provider Demographics
NPI:1164041331
Name:SONRISAS LATINAS MEDICAL GROUP
Entity Type:Organization
Organization Name:SONRISAS LATINAS MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEPERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-830-2866
Mailing Address - Street 1:8648 WOODMAN AVE UNIT 106
Mailing Address - Street 2:
Mailing Address - City:ARLETA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-6503
Mailing Address - Country:US
Mailing Address - Phone:818-830-2866
Mailing Address - Fax:818-830-2856
Practice Address - Street 1:8648 WOODMAN AVE UNIT 106
Practice Address - Street 2:
Practice Address - City:ARLETA
Practice Address - State:CA
Practice Address - Zip Code:91331-6503
Practice Address - Country:US
Practice Address - Phone:818-830-2866
Practice Address - Fax:818-830-2856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty