Provider Demographics
NPI:1164602405
Name:SANDRA SOFINSKI, MD, INC.
Entity Type:Organization
Organization Name:SANDRA SOFINSKI, MD, INC.
Other - Org Name:DOCTORS EYECARE AND HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:SOFINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-948-8148
Mailing Address - Street 1:9550 FREMONT AVE
Mailing Address - Street 2:APT L-7
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2327
Mailing Address - Country:US
Mailing Address - Phone:310-948-8148
Mailing Address - Fax:909-399-0841
Practice Address - Street 1:9550 FREMONT AVE
Practice Address - Street 2:APT L-7
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2327
Practice Address - Country:US
Practice Address - Phone:310-948-8148
Practice Address - Fax:909-399-0841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-04
Last Update Date:2007-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG53790207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty